Thrombosis detection: fibrinogen counting and radionuclide venography.

The occurrence of venous thromboembolic disease is of epidemic proportions and clinical manifestations are clearly documented to be neither sensitive nor specific. Whereas contrast venograms are a suitable reference standard, less invasive procedures are necessary for the clinical management of patients. I-125 FUT is currently the preferred procedure for epidemiological studies and measurement of the efficacy of treatment. It is also suitable for documentation of suspected venous thrombosis in the lower leg and calves. Radionuclide venography, when combined with pulmonary scintigraphy, is useful in the definition of venous thromboembolism. In view of the fact that either the pulmonary emboli or the thrombotic origins may be clinically silent, it is particularly attractive when there is a strong suspicion of either one. It may also be used to document venous thrombosis when that condition is suspected on clinical or other grounds except when calf disease is the only clinical manifestation. Despite the limitations of both of these procedures, they correlate remarkably well with the results of contrast venography and are suitable for routine use.