Clinical History

A 38-year-old patient with high probability lung scan for pulmonary embolism.

Technique

The patient was administered 22 millicuries of technetium-99m Acutect and half-body images of the pelvis and lower extremities were obtained 30 minutes and two hours post injection.

Findings

The initial 30-minute delayed images show asymmetric uptake of the radiotracer in the right femoral vein extending into the right iliac vein. There is diffuse soft-tissue activity seen in the right lower extremity, consistent with soft-tissue edema. Portions of the pelvis are obscured by the distended urinary bladder. On the posterior view, there is the suggestion of some increased accumulation of uptake in the right popliteal vein. Delayed images two hours post injection show markedly increased uptake in the right femoral vein, which appears to extend cephalad into the region of the right iliac vein. On the posterior view, there also is increased activity seen in the right popliteal vein. There is also note made of some slight asymmetry of activity in the right calf and uptake in the right anterior or posterior tibial vein cannot be excluded. Again seen is marked soft-tissue accumulation secondary to soft-tissue edema.

Impressions

UPTAKE OF THE LABELED ANTIBODY IN SITES OF ACTIVE CLOT FORMATION CONSISTENT WITH ACUTE DEEP VENOUS THROMBOSIS IN THE RIGHT FEMORAL VEIN, EXTENDING INTO THE REGION OF THE RIGHT ILIAC VEIN, AND DISTALLY INTO THE RIGHT POPLITEAL AND POSSIBLY SHOWING SOME UPTAKE IN THE RIGHT ANTERIOR OR POSTERIOR TIBIAL VEIN.

Comments

Click here if you would like to view his high probability Lung scan.
Click here if you would like to view his color doppler ultrasound scan.
Click here if you would like to view a negative AcuTect scan.