The Use of Radioisotopic Tests for Diagnosing Lower Limb Venous Thrombosis – Own Research
Languages of publication
Inflammatory mediators play an important role in thrombosis etiopathology. Diagnostic radioisotopic tests can be used to assess the activity of thrombo-inflammatory process.The aim of the study was to assess the suitability of Tc-99m HMPAO labelled leukocyte scintigraphy in the diagnostics of deep vein thrombosis.Material and methods. The study covered 45 patients with lower limb deep vein thrombosis treated in 2009 at the Department of Vascular, General and Transplantological Surgery of the Wrocław Medical University. Scintigraphic test were performed during the first few days after the onset of symptoms and 8 weeks later.Results. All patients with active deep vein thrombosis had higher levels of TC-99m-HMPAO markers in sick limbs. After 8 weeks, 93% of patients still had elevated levels of radioisotope in limbs with an active thrombosis process. However, the levels of markers were clearly lower than in the acute phase of thrombosis.Conclusions. 1. In the chronic phase of thrombosis, 93% of patients still have higher levels of radioisotopic markers, which indicates an active inflammatory process. 2. Tc-99m HMPAO labelled leukocyte scintigraphy demonstrates high sensitivity in the diagnostics of deep vein thrombosis.
1 - 12 - 2012
09 - 02 - 2013
- 1. Agnelli GC: Venous thromboembolism and cancer: a two way clinical association. Thromb Hemost 1997; 78: 456-60.
- 2. Agnelli G, Radicchia S, Nenci GG: Diagnosis of deep vein thrombosis in asymptomatic high-risk patients. Haemostasis 1995; 25: 40-48.[PubMed]
- 3. Ali T, Humphries J, Burnand K et al.: Monocyte recruitment in venous thrombus resolution. J Vasc Surg 2006; 43: 601-08.[PubMed][Crossref]
- 4. Anderson FA, Spencer FA: Risk factors for venous thromboembolism. Circulation 2003; 107: 19-26.
- 5. Caimi G, Canino B, Ferrara F et al.: Leukocyte rheology before and after chemotactic activation in some venous diseases. Eur J Endovasc Surg 1999; 18: 411-16.[Crossref]
- 6. Christiansen SC, Cannegieter SC, Koster T et al.: Thrombophilia, clinical factors and recurrent venous thrombotic events. JAMA 2005; 293: 2352-61.
- 7. Hahn T, Unthank J, Lalka S: Increased hind limb leukocyte concentration in a chronic rodent model of venous hypertension. J Surg Res 1999; 81: 38-41.[Crossref]
- 8. Henke PK, Varga A et al.: Deep vein thrombosis resolution in modulated by monocyte CXCR2-mediated activity in a mouse model. ArteriosclerThromb Vasc Biol 2004; 24: 1130-37.[Crossref]
- 9. Howlader MH, Smith PDC: Symptoms of chronic venous disease and association with systemic inflammatory markers. J Vasc Surg 2003; 38: 950-54.[Crossref][PubMed]
- 10. Hulley S et al.: Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/ Progestin Replacement Study (HERS) Research Group. JAMA 1998; 280: 605-13.
- 11. Luster AD: Chemokines-Chemotactic cytokines that mediate inflammation. N Eng J Med 1998; 338: 436-45.
- 12. McCourt M, Wang JH, Sookhai S: Pro-inflammatory mediators stimulate neutrophil-directed angiogenesis. Arch Surg 1999; 134: 1325-32.
- 13. Myers DD, Hawley AE, Farris DM et al.: P-selectin and leukocyte microparticles are associated with venous thrombogenesis. J Vasc Surg 2003; 38: 1075-89.[PubMed][Crossref]
- 14. Ono T, Bergan JJ et al.: Monocyte infiltration into venous valves. J Vasc Surg 1998; 27: 158-66.[PubMed][Crossref]
- 15. Pascarella L, Schmid-Schönbein GW, BerganJ: An animal model of venous hypertension: The role of inflammation in venous valve failure. J VascSurg 2005; 41: 303-11.
- 16. Peyton BD, Rohrer MJ, Furman MI et al.: Patients with venous stasis ulceration have increased monocyte-plateled aggregation. J Vasc Surg 1998; 27: 1109-16.[Crossref]
- 17. Prandoni P, Bilora F, Marchiori A et al.: An association between atherosclerosis and venous thrombosis. N Eng. J Med 2003; 348: 1425-34.
- 18. Prandoni P, Mannuci M: Dep vein thrombosis of the lower limbs: diagnosis and management. Bailliere,s Clinical Haematology 1999; Vol. 12, No. 3, pp. 533-54.
- 19. Rance A, Emmerich J, Guedj C: Occult cancer in patients with bilateral deep-vein thrombosis. Lancet 1997; 350: 1448-49.
- 20. Reitsma PH, Rosendaal FR: Activation of innate immunity in patients with venous thrombosis. The Leiden Thrombophilia Study. J Thromb Haemost 2004; 2: 619-22.[PubMed][Crossref]
- 21. Ridker PM, Cushman M, Stampfer MJ et al.: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Eng. JMed 1997; 336: 973-79.
- 22. Rosendaal FR: Risk factors for venous thrombosis: prevalence, risk and interaction. Semin Hematol 1997; 34: 171-87.[PubMed]
- 23. Rosendaal FR: Venous thrombosis: a multicausal disease. Lancet 1999; 353: 1167-73.
- 24. Rosenthall L, Leclerc J: A new thrombus imaging agent. Human recombinant fibrin binding domain labeled with In-111. Clinical and NuklaearMed 1995; 20: 398-402.
- 25. Roumen-Klappe EM, den Heijer M, van Uum SH: Inflammatory response in the acute phase of deep vein thrombosis. J Vasc Surg 2002; 35: 701-06.[Crossref]
- 26. Saharay M, Addison IE, Shields A et al.: Leukocyte migration in the leg in response to experimental venous hypertension. J Vasc Surg 1996; 24: 725-31.[Crossref][PubMed]
- 27. Sanson BJ, Simioni P, Tormene D et al.: The incidence of venous thromboembolism in asymptomatic carriers of a deficiency of antithrombin, protein C, or protein S: a prospective cohort study. Blood 1999; 94: 3702-06.
- 28. Santamaria MG, Agnelli G, Taliani MR et al.: Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. ThrombosisResearch 2005; 116: 301-06.
- 29. Shebuski RJ, Kilgore KS: Role of inflammatory mediators in thrombogenesis. J Pharmacol ExpTherapeut 2002; 300: 729-35.
Publication order reference