A retrospective study of the value of indirect CT venography: a British perspective

Slater, Simon J.; Oswal, Dilip; Bhartia, Bobby

doi:10.1259/bjr/28355108

Cited by 8 publications

(10 citation statements)

References 18 publications

(24 reference statements)

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“…gluteal veins) are known causes of false negative CTV studies [ 39 ]. We did not review the isolated cases of positive CTV (without associated positive CTPA) and did not analyze the influence of a positive result of a CTPA on the interpretation of a CTV (and vice versa) [ 40 ]. We did not compare the IOA between 64-slice and 16-slice CT scanners.…”

Section: Discussionmentioning

confidence: 99%

Interobserver Agreement between On-Call Radiology Resident and General Radiologist Interpretations of CT Pulmonary Angiograms and CT Venograms

et al. 2015

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ObjectivesTo evaluate the interobserver agreement (IOA) between the initial radiology resident and the final staff radiologist reports of combined computed tomographic pulmonary angiograms (CTPA) and computed tomographic venograms (CTV) performed during on-call hours.Materials and MethodsApproval by the institutional review board was obtained. Six-hundred and ninety-six consecutive studies (CTPA or CTPA with CTV) performed during on-call hours and interpreted by 30 residents were identified. Radiology residents’ reports were compared to the final staff reports. Three tests outcomes were considered (positive, P; negative, N; indeterminate, I). Discordant cases were reviews by a chest radiologist.ResultsCTPAs were reported by staff radiologists as positive for pulmonary embolism (PE) in 18% (126/694), with a kappa of 0.81 (95% CI 0.77-0.86) with 3 outcomes (P, N, I), and a kappa of 0.89 (95% CI 0.85-0.94) with 2 outcomes (P, N). Regarding PE location, good concordance was observed for positive studies, with a kappa of 0.86 (95% CI 0.78 – 0.95). CTVs were reported as positive by staff radiologists in 8.5% (33/388), with a kappa of 0.66 (95% CI 0.55-0.77) with 3 outcomes (P, N, I), and a kappa of 0.89 (95% CI 0.8-1.0) with 2 outcomes (P, N). The IOA between residents and staff radiologists increased with increasing residency year level for CTPAs, but did not for CTVs.ConclusionsVery good and good IOA were observed between resident and staff radiologist interpretations for CTPA and CTV, respectively, with tendency towards improved IOA as residency level of training increased for CTPA, but not for CTV.

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Section: Discussionmentioning

confidence: 99%

Interobserver Agreement between On-Call Radiology Resident and General Radiologist Interpretations of CT Pulmonary Angiograms and CT Venograms

et al. 2015

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“…However, the overall sensitivity of this modality in detecting DVT is limited. 5 – 7 Previous studies have assessed the merits of computed tomography venography (CTV) in the investigation of LEDVT, as well as pulmonary embolism, with a sensitivity of 89% to 100% and specificity of 94% to 100%. 5 – 9 The techniques used in CTV involve indirect and direct venography of the lower extremities.…”

Section: Introductionmentioning

confidence: 99%

“… 5 – 7 Previous studies have assessed the merits of computed tomography venography (CTV) in the investigation of LEDVT, as well as pulmonary embolism, with a sensitivity of 89% to 100% and specificity of 94% to 100%. 5 – 9 The techniques used in CTV involve indirect and direct venography of the lower extremities. 5 , 10 , 11 In clinical practice, indirect CTV is the most frequently used technique and usually adds to CT pulmonary angiography.…”

Section: Introductionmentioning

confidence: 99%

“… 5 – 9 The techniques used in CTV involve indirect and direct venography of the lower extremities. 5 , 10 , 11 In clinical practice, indirect CTV is the most frequently used technique and usually adds to CT pulmonary angiography. Both of these techniques are a package protocol so that identification of pulmonary embolism and/or LEDVT can be processed in batches.…”

Section: Introductionmentioning

confidence: 99%

“…Both of these techniques are a package protocol so that identification of pulmonary embolism and/or LEDVT can be processed in batches. 5 , 11 The main disadvantage of indirect CTV is poor attenuation of deep veins that is usually associated with individual differences in circulation time of contrast medium reaching the limbs. Therefore, imaging quality might be compromised because of the lower density contrast between background and veins.…”

Section: Introductionmentioning

confidence: 99%

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Combined Direct and Indirect CT Venography (Combined CTV) in Detecting Lower Extremity Deep Vein Thrombosis

Shi

Wang

et al. 2016

Medicine

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This study aimed to evaluate the diagnostic accuracy of combined direct and indirect CT venography (combined CTV) in the detection of lower extremity deep vein thrombosis (LEDVT).The institutional review board approved the study protocol, and patients or qualifying family members provided informed consent. A total of 96 consecutive patients undergoing combined CTV were prospectively enrolled. A combined examination with digital subtraction angiography (DSA) plus duplex ultrasonography (US) was used as the criterion standard. Three observers were blinded to clinical, DSA, and US results, and they independently analyzed all combined CTV datasets. Interobserver agreement was expressed in terms of the Cohen k value for categorical variables. Accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of combined CTV in the detection of LEDVT were determined by using patient- and location-based evaluations.Of the 96 patients, DSA plus US revealed LEDVT in 125 segmental veins in 63 patients. Patient-based evaluation with combined CTV yielded an accuracy of 96.9% to 97.9%, a sensitivity of 95.2% to 96.8%, a specificity of 100% to 100%, a PPV of 100% to 100%, and an NPV of 91.7% to 94.3% in the detection of LEDVT. Location-based evaluation yielded similar results. Through combined direct and indirect CTV, patients obtained a combined CT angiogram on the diseased limb and an indirect CT angiogram on the opposite side. The image quality of combined CTV was superior to an indirect venogram.Combined CTV shows promising diagnostic accuracy in the detection of LEDVT with 3-dimensional modeling of the lower limb venous system.

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Mid- and Short-Term Efficacy of Percutaneous Mechanical Thrombectomy in the Treatment of Acute Iliofemoral Deep Vein Thrombosis

Cao

Sheng

et al. 2020

Annals of Vascular Surgery

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A retrospective study of the value of indirect CT venography: a British perspective

Abstract: In a UK-based practice, the incidence and the proportion of isolated DVT diagnosed by CTV are lower than expected from published data. An analysis of possible causes for this is made within the paper.

Cited by 8 publications

References 18 publications

Interobserver Agreement between On-Call Radiology Resident and General Radiologist Interpretations of CT Pulmonary Angiograms and CT Venograms

Interobserver Agreement between On-Call Radiology Resident and General Radiologist Interpretations of CT Pulmonary Angiograms and CT Venograms

Combined Direct and Indirect CT Venography (Combined CTV) in Detecting Lower Extremity Deep Vein Thrombosis

Mid- and Short-Term Efficacy of Percutaneous Mechanical Thrombectomy in the Treatment of Acute Iliofemoral Deep Vein Thrombosis

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