Comparison of duplex ultrasonography and venography in the diagnosis of deep venous thrombosis

Abstract

Sixty-five patients with suspected deep venous thrombosis (DVT) in 68 limbs were entered consecutively into a study to compare venography with duplex ultrasonography scanning. Both tests were performed on 64 limbs, venography being contraindicated in four. Overall, duplex scanning correctly identified 86 per cent of DVTs diagnosed on venography and correctly excluded 80 per cent with negative venograms. Nearly all errors arose in the diagnosis of calf DVT. In the femoral vein duplex scanning had a specificity of 100 per cent and a sensitivity of 95 per cent. In addition, duplex scanning provided data on the limb not undergoing venography. Of 55 limbs that underwent bilateral duplex scanning, five had thrombus in the femoropopliteal segment and a negative contralateral venogram. In addition, three Baker's cysts were diagnosed. Duplex scanning can be used in patients in whom venography is contraindicated and may also provide information about the contralateral limb. We regard femoropopliteal duplex scanning as sufficiently accurate that treatment can be initiated on the basis of the scan. Duplex scanning should replace venography as the standard method of diagnosing femoropopliteal DVT; radiographic studies should now be required only when the scan result is in doubt.

Pharmacomechanical Catheter-Directed Thrombolysis for Pregnancy-Related Iliofemoral Deep Vein Thrombosis

“…The diagnosis and anatomic extent of DVT are best assessed initially with compression duplex US, although this may be less accurate in the pelvic or calf veins (14). The presence or absence of calf vein thrombosis rarely affects the decision whether to pursue endovascular therapy.…”

Chronic Venous Insufficiency and Venous Ulceration

“…As compared with venography, sensitivity ranges from 86% to 96% and specificity from 80% to 100%, with most errors occurring in the calf or popliteal veins. [54][55][56][57][58] In the diagnosis of DVT, the criteria with the highest combined sensitivity and specificity, at 92% each, are absence of spontaneous venous flow and absent phasicity of flow with respiration. 57 B-mode ultrasonography also has the advantage of visualizing other anatomic structures in the leg that can produce pain or swelling and mimic venous disease, such as ruptured or dissecting popliteal cysts, soft tissue hematomas, arterial aneurysms, and soft-tissue masses.…”

Epidemiologic analysis of proximal deep vein thrombosis in thai patients: Malignancy, the predominant etiologic factor

“…Duplex ultrasonography was the sole diagnostic tool used to determine a positive diagnosis of DVT in this study period. The criteria used for determining positive findings of DVT were the visualization of a thrombus, the presence of a noncompressible deep vein, the absence of a spontaneous flow signal of the highest sensitivity scale, or the absence of a spontaneous color filling the lumen [9][10][11]. The deep veins subjected to investigation were the iliac (n: 3070), femoral (n: 3070), popliteal (n: 3070), and subclavian (n: 40).…”