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Detection of deep venous thrombosis on labeled leukocytes scan


Authors: Štěpán Kozák 1;  Otto Lang 1,2
Authors‘ workplace: Klinika nukleární medicíny, 3. LF UK a FNKV, Praha 10, ČR 1;  Oddělení nukleární medicíny, Oblastní nemocnice Příbram, a. s., Příbram, ČR 2
Published in: NuklMed 2017;6:67-69
Category: Casuistry

Overview

This case report presents a 65 year-old man after total hip replacement who was admitted to the neurological department with lower back pain irradiating to his right thigh. He underwent labeled leukocytes scintigraphy in order to rule out septic loosening of the hip replacement. This examination found increased accumulation of labeled leukocytes in soft tissue of the right thigh medial to the femoral bone. During the next days patient started to suffer from dyspnea. He underwent CT pulmonary angiography, with finding of massive bilateral pulmonary embolism. After that venous sonography of lower extremities was performed confirming a deep venous trombosis in the right lower extremity. The aim of this case report is to present a rare case of pathological accumulation of labeled leukocytes which is most probably not caused by an infection but phlebothrombosis.

Key words:
deep vein thrombosis, lung embolism, 99mTc-labeled leukocytes scintigraphy, bone marrow scintigraphy, SPECT/CT


Sources

1. D‘Alonzo WA, Alavi A. Detection of Deep Venous Thrombosis by Indium-111 Leukocyte scintigraphy. Journal of Nuclear Medicine 1986;27:631-633

2. Blount C, Balon H. Deep Venous Thrombosis Shown on In-111 Labeled White Blood Cell Imaging. Clinical Nuclear Medicine 1997;22:261-262

3. Carvalho P, Banerjee AK, Cheah FK et al. Case Report: deep venousthrombosis diagnosed on Indium-111 labeled white cell scanning. Clinical Radiology 1991;43:276-277

4. Fancher M, Abghari R, Bartold K. Initial detection of lower extremity septic deep venous thrombophlebitis by Indium-111 WBC imaging in a patient with bacteremia. Clin Nucl Med 1986;11:206-208

5. Janczak D, Janczak P, Skóra J. The use of radioisotopic tests for diagnosing lower limb venous thrombosis. Polish journal of surgery 2012;84:605-612

6. Palestro Ch, Love Ch, Tronco G et al. Combined Labeled Leukocyte and Technetium 99m Sulfur Colloid Bone Marrow Imaging for Diagnosing Musculoskeletal Infection. Radiographics 2006;26:859-870

Labels
Nuclear medicine Radiodiagnostics Radiotherapy
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