[Radionuclide venography in occlusions of the inferior vena cava]. / Radionuklidová venografie pri uzáverech dolní duté zíly.

Based on 1234 examinations made by radionuclide venography the authors evaluated a group of 11 patients, where an occlusion of the vena cava was proved. In five instances ascension of thrombosis from the area of the pelvic veins was involved. in three instances compression by a tumour, twice the cause of occlusion was surgical ligature of the vena cava inferior. In one instance suppurative thrombosis developed as a result of spread of the infection from an intraabdominal abscess. Radionuclide venography provided evidence of a collateral circulation, as a rule a combination of several collateral routes was involved. Most frequently parietal collaterals in the abdominal aorta were present (9X), 4X paravertebral venous routes and only once anastomoses into the system of the azygos vein. In six patients anastomoses via the portal vein were found (cavoportal anastomoses). Based on their own experience, the authors evaluated the importance of radionuclide venography. Its advantage is the possible administration of the radiopharmaceutical preparation into the peripheral vein on the leg, the simple, safe procedure, the reproducibility and diagnostic yield during detection of high occlusions in the area of the vena cava inferior.

Use of radionuclides in the diagnosis of thromboembolism of venous origin: its potential and limitations. A review.

The review discusses the potential and limitations of radionuclide (RN) techniques of examination in diagnosing thromboembolic disease of venous origin. The advantages and drawbacks of perfusion pulmonary scintigraphy as the most commonly used method are weighed especially with a view to the diagnosis of pulmonary embolism (PE). The need for a combined examination including inhalation scintigraphy and chest X-ray is underlined. The criteria for interpreting results of RN techniques of examination in assessing the presence of PE are defined. Of the methods used in the diagnosis of venous thrombosis, the benefits and limitations of the fibrinogen uptake test (FUT) and radionuclide venography (RNV) are pointed out. When comparing RNV with X-ray phlebography, the authors found a low sensitivity in the crural area (54%) and, on the contrary, a 100% agreement in the areas of iliac veins and the vena cava inferior.

[Comparison of radionuclide venography with roentgen phlebography]. / Srovnání radionuklidové venografie s rtg-flebografií.

The authors evaluated a group of 78 patients where in addition to radionuclide venography (RNV) also X-ray phlebography was used (RTGF) within a time interval of not more than 72 hours. The results of 102 examinations were compared, 276 areas were correlated at six different sites. Agreement was recorded in 249 instances (90%), a false negative finding in 23 (8%) and a false positive finding in 4 (2%). Sensitivity was low in the area of the calf (55%), high in the femoral area, iliac area and in the area of the inferior vena cava (92-100%). The specificity was in all areas, incl. the calf, relatively high (94-100%). The investigation revealed the disadvantages of RNV--a low reliability in the area of the calf, the impossibility to detect small and parietal thrombi, the inability to assess the "activity and age" of the thrombus, the more difficult interpretation in insufficiency of venous perforators, and advantages of RNV--a great reliability at higher parts of the venous system and after administration of radiopharmaceutical preparations (RF) into peripheral veins, the possibility of simultaneous examination of pulmonary perfusion without further administration of RF, a low failure rate of intravenous administration of RF (less than 2%); RF do not irritate the venous endothelium and therefore thrombosis cannot develop; in case of paravenous escape of RF local inflammations do not develop, the radiation load is low, there is a small probability of allergic reactions, the method is non-invasive, it can be frequently repeated and used for the follow-up of treatment.

[Initial experience with autologous thrombocytes labeled with 111indium-oxine]. / První zkusenosti s autologními trombocyty znacenými 111indium-oxinem.

The authors elaborated their own modification of the separation and labelling of autologous thrombocytes by means of 111indium-oxine which can be implemented in Czechoslovak departments of nuclear medicine with standard equipment. A total of 123 separations and labellings were made and 85 administrations to patients. The effectiveness of labelling by the described method was 79.5 +/- 6.9%, the separation yield of thrombocytes with regard to complete blood 44.3 +/- 13.8%. The aggregating capacity of the labelled platelets assessed in vitro after ADP stimulation (adenosine diphosphate) was 39.5 +/- 10.1% difference in optic density of platelet rich and platelet poor plasma which is evidence of the preserved viability of thrombocytes. "Recovery" during the 120th minute after administration of normal suspensions was 62.2 +/- 17.9%, the survival time of labelled thrombocytes 8.2 +/- 0.74 days. In patients with idiopathic thrombocytopenic purpura the "recovery" was 49.4 +/- 18%, the survival period 2.9 +/- 1.8 days. In patients after transplantation of the kidney complicated by acute rejection there was an increased accumulation of labelled platelets in the area of the kidney (count rate index 2.32 +/- 0.45). In normally functioning transplanted kidneys the count rate index was 1.42 +/- 0.06. On their own material the authors demonstrate other possibilities of clinical application of scintigraphy by means of labelled autologous platelets (a method hitherto not described in the Ccezhoslovak literature) for the detection of intracardial and arterial thrombosis.