99Tcm-大颗粒聚合白蛋白显像在下肢深静脉血栓中的诊断价值

The value of 99Tcm-MAA radionuclide venography in detection of deep vein thrombosis of the lower limbs

    摘要
  • 摘要:
    目的 探讨99Tcm-大颗粒聚合白蛋白（99Tcm-MAA）核素深静脉显像（RNV）对下肢深静脉血栓(DVT)的诊断价值。
    方法 临床疑似下肢DVT的患者45例，均行99Tcm-MAA双下肢RNV，并与临床最终诊断结果进行对照。
    结果 43例共51条患肢经临床确诊，51条血栓性患肢中，左下肢36条、右下肢15条，左下患肢数明显多于右下患肢，左、右患肢数之比为2.4∶1。99Tcm-MAA RNV共检出下肢DVT阳性患者38例，共44条患肢，其中，12例患者同时获得肺动脉栓塞诊断。99Tcm-MAA显像诊断下肢DVT的灵敏度、特异度和准确率分别为86.3%、92.3%和88.9%。下肢深静脉各段均可形成血栓，以髂、股静脉段患病率最高。
    结论 RNV不仅能对下肢DVT作出定位诊断，而且能清晰显示侧支及交通支血管部位、行径及与阻塞部位的关系，有助于肺动脉栓塞的诊断，该检查具有无创、灵敏度高、准确及可重复应用等优点。

     

    Abstract:
    Objective To explore the value of 99Tcm-magroaggregated albumin(99Tcm-MAA)radionuclide venography(RNV)in detection of deep vein thrombosis(DVT)of the lower limbs.
    Methods Forty five patients clinically suspected as DVT were examined by 99Tcm-MAA RNV.
    Results Forty-three cases were diagnosed as DVT by clinical method and 51 limbs were confirmed.The numbers of left limbs with thrombosis(36)were more than the right(15), with the ratio was 2.4∶1.Thirty-eight cases were diagnosed as DVT by RNV and 44 limbs were concerted.Moreover 12 cases of pulmonary embolism were found.The sensitivity, specificity and accuracy of 99Tcm-MAA RNV were 86.3%, 92.3%and 88.9%.DVT could be found in every venous segments of the crura.The incidence rate of thrombosis was highest in segments of the femoral-iliac vein.
    Conclusion RNV can not only obtain the localization diagnosis of DVT of the lower limbs, but also demonstrate clearly the path of lateral branch vessel and the connection with blockage.It is a noninvasive, highly sensitive, accurate and repeatable method for diagnosis of DVT.

     

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