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Biomedical subjects

C G Olsson

Publications and source records attributed to C G Olsson.

4 recordsLinked to original sources

Thrombosis after phlebography: a comparison of two contrast media.

In two studies 267 consecutive patients with suspected leg vein thrombosis were examined by an 125I-fibrinogen uptake test (125I-FUT) and by phlebography. The ionic meglumine calcium metrizoate (Isopaque Cerebral) was used as the phlebographic contrast medium in 161 patients, and the non-ionic metrizamide (Amipaque) was used in 106. In these two groups 47 and 41 patients, respectively, had normal phlebograms as well as an initially normal 125I-FUT. After phlebography 29 (62%) of the patients who had received meglumine metrizoate had a significant rise in fibrinogen uptake, while such a rise was not found in patients examined with metrizamide. Repeat phlebography showed fresh deep-vein thrombosis in seven of the nine patients with increased uptake, indicating a complication rate of 48%. Consequently, we now use metrizamide in leg phlebogrphy; because of its expense a radioisotope test is employed as a screening procedure.

Adolescent

Thrombosis following phlebography with ionic and non-ionic contrast media.

The side-effects at phlebography of the lower limb were evaluated using an ionic contrast medium, meglumine-metrizoate, and a non-ionic contrast medium, metrizamide. A post-phlebographic accumulation of 125I-fibrinogen was found in 6 patients examined with meglumine-metrizoate indicating a post-phlebographic thrombosis. Ten patients were examined with metrizamide with no post-phlebographic increase in 125I-fibrinogen uptake. Though the groups are small the difference is statistically significant at the 0.2 per cent level.

Fibrinogen

A modified [125I]fibrinogen technique for thrombus detection in the whole leg.

The [125I]fibrinogen uptake test was modified to give a quick result, and improve sensitivity and specificity in the diagnosis of deep venous thrombosis (DVT). At least 800 counts were recorded at each measuring point. The leg veins were emptied more effectively. Thus the proximal thigh could be evaluated and the influence of varicose veins reduced. The feet and the leg points were measured in a zig-zag order (from side to side) to avoid systematic errors in early diagnosis. The modified test detected 62% of the thrombi 1 h after injection, 82% after 1 day and 95% after 2 days. The method still lacks in specificity; this is unavoidable since fibrin accumulates in various other conditions than DVT. The combination of high sensitivity and low specificity makes the modified test reliable as a screening procedure, but not as an independent method.

Adult

Thrombotic side-effects of lower-limb phlebography.

In 20 of 61 patients with initially normal phlebograms, uptake of 125I-labelled fibrinogen subsequently increased. In 4 (7%) cases, independent examinations (pulmonary scintigram or a new phlebogram) demonstrated a thromboembolic or thrombotic process. These results suggest that thrombosis and embolism may be caused by phlebography.

Adult