Radionuclide venography and labeled platelets in deep venous thrombosis

Evidence of Subclavian Vein Thrombosis on First-Pass 18FDG PET in a Patient with Relapsing Upper Mediastinum Lymphoma

Baseline ¹⁸F-FDG PET was performed in a 74-year-old patient with relapsing upper mediastinum lymphoma. Left subclavian thrombosis was suspected on prior contrast-enhanced CT. Dynamic PET imaging was achieved during 3 min after IV injection of ¹⁸F-FDG to the left arm in order to further assess left subclavian vein permeability. The 20-s dynamic frame at 1 min after injection confirmed the absence of flow in the left subclavian vein and evidenced the derivation of ¹⁸F-FDG through left axillary, then superficial, then right internal mammary collaterals to the superior vena cava, hence confirming the subclavian thrombosis.

Advanced imaging in acute and chronic deep vein thrombosis

Deep venous thrombosis (DVT) affecting the extremities is a common clinical problem. Prompt imaging aids in rapid diagnosis and adequate treatment. While ultrasound (US) remains the workhorse of detection of extremity venous thrombosis, CT and MRI are commonly used as the problem-solving tools either to visualize the thrombosis in central veins like superior or inferior vena cava (IVC) or to test for the presence of complications like pulmonary embolism (PE). The cross-sectional modalities also offer improved visualization of venous collaterals. The purpose of this article is to review the established modalities used for characterization and diagnosis of DVT, and further explore promising innovations and recent advances in this field.

Application of upper extremity radionuclide venography as a diagnostic approach for Port-A catheter thrombosis

BACKGROUND

To investigate the role of upper extremity radionuclide venography as a potential diagnostic modality in the assessment of venous thrombosis associated with a Port-A catheter.

METHODS

Fourteen symptomatic patients who had received Port-A catheter implantation were enrolled. A dynamic nuclear medicine flow study was performed with intravenous administration of Technetium-99m macroaggregated albumin to both upper extremities. Imaging patterns of the venous system were categorized as patency, partial obstruction, and total occlusion.

RESULTS

The findings of the dynamic images clearly demonstrated clinical problems. Three patients were free of a definite venous flow change. Three patients had partial obstruction of venous return. A significant cut-off of venous return was demonstrated in 8 patients, and total occlusions were hence diagnosed. All patients underwent this procedure smoothly without any complication.

CONCLUSION

These results suggest that upper extremity radionuclide venography is an easily performed and effective method for diagnosing Port-A catheter thrombosis in clinical practice.