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Original ArticleOpen Access
Radionuclide Venography in the Diagnosis of Deep Vein Thrombosis of the Lower Extremities: A Comparison to Contrast Venography
Mangkharak J 
,
Chiewvit S ,
Chaiyasoot W ,
Pusuwan P ,
Permpikul C ,
Toopmongkol C ,
Sriprapapom W
,
Chiewvit S ,
Chaiyasoot W ,
Pusuwan P ,
Permpikul C ,
Toopmongkol C ,
Sriprapapom W Radionuclide venography (RNV) and contrast venography (CV) were compared in 72
limbs of 59 patients being clinically suspected of deep vein thrombosis (DVT) of the lower
extremities. The criteria of positive RNV for DVT regarding flow pattern abnormailty included
(1) nonfilling or nonvisualization of a deep vein, (2) interruption of the flow, (3) irregular or
asymmetric filling of a deep vein, and ( 4) presence of abnormal collateral vessels. The overall
accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value
(NPV), and positive likelihood ratio (LR+) were 90 per cent, 88 per cent, 96 per cent, 98 per cent, 79
per cent, and 20.8 respectively. These figures are even higher when we focused on the major veins
of the thigh and pelvis. They were 97 per cent, 95 per cent, 98 per cent, 98 per cent, 95 per cent,
and 61 respectively. The results indicates that radionuclide venography, while technically simple,
is a reliable test for detection of DVT particulary of the major veins of the lower extremities.
Combined radionuclide venography and perfusion lung scan can also be performed in the same
setting if Tc99m-MAA is used. Contrast venography which is an invasive procedure, should be
reserved for questionable cases or those with suspected isolated calf vein thrombosis.
limbs of 59 patients being clinically suspected of deep vein thrombosis (DVT) of the lower
extremities. The criteria of positive RNV for DVT regarding flow pattern abnormailty included
(1) nonfilling or nonvisualization of a deep vein, (2) interruption of the flow, (3) irregular or
asymmetric filling of a deep vein, and ( 4) presence of abnormal collateral vessels. The overall
accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value
(NPV), and positive likelihood ratio (LR+) were 90 per cent, 88 per cent, 96 per cent, 98 per cent, 79
per cent, and 20.8 respectively. These figures are even higher when we focused on the major veins
of the thigh and pelvis. They were 97 per cent, 95 per cent, 98 per cent, 98 per cent, 95 per cent,
and 61 respectively. The results indicates that radionuclide venography, while technically simple,
is a reliable test for detection of DVT particulary of the major veins of the lower extremities.
Combined radionuclide venography and perfusion lung scan can also be performed in the same
setting if Tc99m-MAA is used. Contrast venography which is an invasive procedure, should be
reserved for questionable cases or those with suspected isolated calf vein thrombosis.
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