Detection of thrombophlebitis in the lower extremities: a regional comparison of 123I fibrinogen scintigraphy and contrast venography

123I fibrinogen scintigraphy and contrast venography were compared in 43 patients suspected of having thrombophlebitis. A total of 69 legs and 268 regions were available for comparison. Of 43 patients, 31 had venographic signs of thrombophlebitis. When venography was used as a standard, scintigraphy had a sensitivity and accuracy equal to or greater than 90%, regardless of whether the comparison was made for patients, legs, or regions. There was complete agreement in the iliac region between venography and scintigraphy. Beyond inherent differences between the procedures, the few discrepancies between venography and scintigraphy could be explained by circumstances, such as interval between procedures, heparin treatment, limited disease, and procedural deficiencies. The accuracy of 123I fibrinogen scintigraphy, its simplicity, and absence of morbidity make it an attractive diagnostic procedure in patients suspected of having thrombophlebitis. A major limitation of 123I fibrinogen scintigraphy is the lack of general availability of a suitable, commercial radiopharmaceutical at present.
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