In a prospective study, 121 consecutive patients with a clinical diagnosis of deep venous thrombosis of the leg were examined with real-time ultrasonography. The findings were correlated with the results of venography. The common femoral vein and the popliteal vein were evaluated for intraluminal echoes and compressibility, and the common femoral vein was also evaluated for an increase in diameter in response to the Valsalva maneuver. The superficial femoral vein and the calf veins were not evaluated. The results indicate that compressibility of the common femoral and popliteal veins is the best indication of deep venous thrombosis, with a sensitivity of 96% and a specificity of 97%. The accuracy of detection was not improved by including data from thrombus visualization or the response of the common femoral vein to the Valsalva maneuver.
Venous DSA of the renal arteries was performed in 32 patients for suspected renovascular hypertension who were considered for percutaneous transluminal angioplasty (PTA). To trace the causes of contradictory or divergent findings in our material, v-DSA and conventional angiography prior to PTA were compared. Superimposition of dense bone structures on the origins of the renal arteries was the most common cause of different findings. In 22 arteries with superimposition, 11 were not the same (50%). In 42 arteries without superimposition 7 were not comparable (16.5%). The difference between both groups is statistically significant (chi square test: p less than 0.05). Other possible factors of influence such as motion artifacts, superimposition of vessels and calcifications in the region of the renal arteries, had no measurable effect. The importance and the origin of subtraction artifacts caused by dense bone structures are discussed.
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