- 期刊
Diagnosis of Port-A Catheter-Induced Thrombosis by Upper Extremities Radionuclide Venography
核子醫學上肢靜脈造影診斷Port-A導管引起之阻塞性血栓
摘要
臨床上為需要長期靜脈給藥的患者，如惡性腫瘤接受化學治療或腸道外營養給藥的情形，建立Port-A catheter做為中央靜脈給藥的途徑是廣泛且有效的作法。然而此方法常有合併症出現，其中尤以血栓形成最為嚴重，因此早期診斷並以抗凝血藥物治療相當重要。此案例中，患者因接受Port-A catheter置放後出現上肢腫脹等疑似血管栓塞的症狀而求診，其於靜脈血流造影下清楚呈現靜脈迴流受阻的影像，也由此建立出左鎖骨下靜脈栓塞之診斷，其後進行的電腦斷層造影也確認此一診斷。由此發現，對於需要初步評估以排除或建立診斷的狀況下，核子醫學上肢靜脈造影除有其操作簡便的好處外，也是作為快速判定靜脈阻塞的良好工具。
並列摘要
Port-A catheters are used as the essential devices for chemo-drug administration through intravenous route in patients with malignancy. However, they were associated with some troublesome clinical complications, especially the thrombosis. We report a case of suspected upper extremity venous thrombosis after Port-A catheter implantation. Nuclear medicine flow studies demonstrated clearly the obstructed venous return from this patient. Therefore, venous thrombosis in his left subclavian vein was diagnosed. Follow up CT scan confirmed this diagnosis. This image finding suggests that radionuclide venography is easy-performed and showing valuable clinical benefit for investigation of upper venous condition.