심부정맥혈전증 검사시 Tracker 기법의 유용성 평가

The Availability of Tracker Method in Deep Vein Thrombosis

Purpose In deep vein thrombosis test, 180sec latency test, one of existing test methods, has less accuracy of diagnosis because the image of venous thrombosis may be shown differently according to the status of cardiac output, artery occlusion, etc. thus in the present study, an attempt was made to look into the clinical availability of the new test method of performing test at the peak of a time-threshold curve for popliteal veins by using tracker method of multi-detector computed tomography. Materials and methods A retrospective study was made for total 32 patients consisting of 16 patients who took the existing test and 16 patients who took the new test among patients who visited the hospital between May and July 2008 and took deep vein thrombosis test. Using tracker method of the new test method, threshold was set to be high for popliteal veins, and tracking was started 50 seconds after beginning angiography, and when the tracking time curve started to bend downward from the peak of the threshold, test was done together with injection of a cell line in order to reduce arteriography. After test, comparison on the images between existing test method and new one was made and they went through statistical analysis, and based on these, the availability of those images in deep vein thrombosis test was evaluated. Results For thrombosis parts of total 32 patients who took deep vein thrombosis diagnosis, in existing test group, they were mainly found in large blood vessels of the pelvis and abdomen by order of iliac veins, femoral veins, and popliteal veins, while in new test group, they were equally found in popliteal veins, iliac veins, and femoral veins. This result implies that the existing test method has limitations in identifying the extent of the proximal portion for venous thrombosis according to the patient’s cardiac output, artery occlusion, etc. On the other hand, it was pointed out that the new test method showed a highly contrast-enhanced image of arteries, but the quality of image of venous phase could be raised by injection of a cell line. As a result of analysis by statistics of independent sample t-test between existing test group and new test group, a significance level was shown to be(p<0.05)p=0.008, which indicates there was statistically significant difference. Conclusion In the new test method, significantly high incidence of thrombosis was found with development of multi detector computed tomography, thus the new test method is deemed as more useful method in terms of objectivity and accuracy of diagnosis, compared to the existing test method. It is concluded that more prospective studies are required to be made for establishment of protocol with many cases.