The Value of Half-Body Technetium-99m-Labeled Red Blood Cells Subcutaneous Radionuclide Venography in Differential Diagnosis of Lower Extremities Edema

放射性同位素静脈造影是一種非侵入性的技術，可用來篩檢懷疑是深部靜脈血栓的病人。在我們的醫院，有很多下肢腫脹的病人接受我們改良的皮下注射鎝-99m體内標幟紅血球之半身靜脈造影來排除下肢深部靜脈血栓的可能性。除了靜脈血流之外，我們還可以從血池相的影像上獲得其他的資訊，包括：血管狀態，腫塊，發炎充血等。本文報告了兩個病例。病例一是一位57歲的中風男性病人，右下肢突然發生腫脹，在静脈造影的血池相可以看到腫脹的右大腿呈現充血狀態，中間有一個線狀的冷區，後來開刀證實是一個血腫塊，開刀清除後病人症狀就改善了。病例二是一個66歲的女性病人，主訴是右腳腫脹，在静脈造影的血池相可以看到深部靜脈血流仍暢通，然而右膝關節處卻呈現充血狀態，在後來的三相骨骼掃描中認爲在膝關節處是感染性膝關節炎，在持續的抗生素治療下，病人的症狀就改善了。由此得知非侵入性的皮下注射鎝-99m體内標幟紅血球之半身静脈造影不只是可以用來診斷下肢的深部靜脈血栓，也可以進一步幫助臨床醫師鑑別診斷下肢腫脹的原因。

關鍵字

皮下注射放射性同位素脈造影；下肢腫脹；血腫；感染性膝關節炎

並列摘要

Radionuclide venography(RNV)is a useful screening technique on patients with clinically suspicious deep vein thrombosis(DVT)of lower extremities. In our hospital, many patients with lower extremities edema received(superscript 99m)Tc-labeled red blood cells((superscript 99m)Tc-RBCs)subcutaneous RNV(SC-RNV)to rule out DVT. In addition to venous flow,(superscript 99m)Tc-RBCs SC-RNV images also provide other useful information including vascularity, space-occupying lesion and inflammatory hyperemia, etc. In this article, we reported two cases of clinically suspicious DVT but proved to be other disorders according to the image of SC-RNV. First case was a57-year-old male patient with stroke history. He suffered from right lower extremity edema for about ten days Blood pool image of(superscript 99m)Tc-RBCs SC-RNV showed hyperemia in the right swelling thigh with a linear photopenic defect .Surgical intervention and pathological result demonstrated a huge hematoma in the right thigh Second case was a 66-year-old female patient She suffered from right lower extremity edema for about1 week combined with fever and right knee joint pain(superscript 99m)TC-RBCs SC-RNV blood pool image showed deep venous flow and hyperemia over the right knee area(superscript 99m)Tc-MDP three-phase bone scan revealed active bone lesion involving the right knee and septic knee was considered. After antibiotic treatment, the symptoms improved. We conclude that(superscript 99m)Tc-RBCs SC-RNV is a useful and non-invasive procedure which assists clinicians in differential diagnosis of lower extremities edema, not only in detecting DVT.

並列關鍵字

subcutaneous radionuclide venography ； lower extremities edema ； hematoma ； septic arthritis

國際替代計量

The Value of Half-Body Technetium-99m-Labeled Red Blood Cells Subcutaneous Radionuclide Venography in Differential Diagnosis of Lower Extremities Edema

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