Technetium 99m-plasmin: a new test for the detection of deep vein thrombosis

Abstract

Deep vein thrombosis (DVT) is a common medical problem requiring early diagnosis and treatment in order to prevent serious sequelae. Currently available diagnostic aids are suboptimal, since they are either invasive (phlebography), insensitive (ultrasound), or slow (¹²⁵I-fibrinogen uptake test). The ⁹⁹Tc^m-plasmin test was compared with the ¹²⁵I-fibrinogen uptake test. The results were concordant in 38 of 40 cases studied (11 concordant positive and 27 concordant negative); a significant correlation (p < 0.05) was found. In a further 20 patients, the ⁹⁹Tc^m-plasmin uptake test was compared with X-ray contrast phlebography. In this series, 12 patients presented with concordant negative results, five patients with concordant positive results and three patients with a positive ⁹⁹Tc^m-plasmin uptake test in the presence of a negative phlebogram. Of these three cases, two presented with clinical evidence of pulmonary embolism and positive perfusion/ventilation lung scans. ⁹⁹Tc^m-plasmin appears to have the potential for early and rapid screening of deep-vein thrombosis 15 minutes after intravenous injection. The test is safe, quick, economic and easy to perform.