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What is the mechanism of false-positive 125I-labelled fibrinogen scans in the detection of venous thrombosis?
What is the mechanism of false-positive 125I-labelled fibrinogen scans in the detection of venous thrombosis?
False-positive 125I-fibrinogen scans for venous thrombosis can occur up to 48 hours after thrombus resolution due to persistent fibrin deposition and inflammatory changes in the vein wall.
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Caution interpreting positive 125I scans up to 48h after possible thrombus resolution; hypothesis-generating in animal models, requiring human validation.
S ummary . When 125 I‐fibrinogen scanning is used for the early detection of venous thrombosis, comparison with venography has shown a small percentage of abnormal scans associated with normal venograms. The mechanism of this discrepancy was investigated in an experimental model. Venous thrombosis was produced in 56 dogs using stasis and local thrombin. The data obtained from scanning and venography were validated by direct vein examination. 125 I scanning agreed in 96% with venography when thrombus was present, but when thrombus lysed or embolized scans continued to read positive even though venograms were negative. Deliberate embolization of thrombi showed that these false positive scans continued for up to 48 hr owing to activity persisting in the vein wall. This was shown on histology to be related to fibrin deposition in the sub‐endothelial and adventitial layers with inflammatory changes.
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Kerrigan et al. (1974) studied this question.
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