Lower-extremity deep venous thrombosis: further experience with and refinements of US assessment.

Abstract

During a 1-year period, 537 compression ultrasound (CU) examinations were performed in 506 extremities of 485 patients for evaluation of possible deep venous thrombosis (DVT). Decisions regarding therapy were based on the result of this test in both outpatients and inpatients. Doppler ultrasound was also used during the last 7 months of the study, but this procedure did not alter the results obtained with CU alone. Incidental findings (eg, Baker cysts, aneurysms, and lymph nodes) were noted in 42 patients and were thought to be nonthrombotic causes of leg swelling or pain that could not be detected with venography. The reliability and clinical acceptance of CU as a means of diagnosing lower-extremity DVT resulted in a 50% yearly reduction in venography, with a concomitant 130% increase in the number of cases of DVT diagnosed.

Prevalence of Deep-Vein Thrombosis of the Leg in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

“…US has proved to be a quick, noninvasive, repeatable, inexpensive, widely available, rapidly learned means for the diagnosis of DVT of the lower extremity. Conversely, the accuracy of US has been extensively analyzed in controlled studies with venography, establishing an overall sensitivity of 95% and a specificity of 99% regarding suspected DVT [8,9,18]. In asymptomatic high-risk patients Wells et al [19] compared duplex sonography (additionally the blood flow is detected with pulsed Doppler and visualized) with venography as a screening method; the sensitivity of duplex sonography was 60% and its specificity was 98%.…”

“…A noninvasive and portable alternative is real-time B-mode compression ultrasonography (US). A comparison of phlebography with duplex US has disclosed that US has an acceptable diagnostic accuracy in detecting DVT of the lower extremity [8][9][10][11].…”

Clinically Important Pulmonary Emboli: Does Calf Vein US Alter Outcomes?

“…US was generally performed with 5-MHz linear-array transducers by using compression as well as with color and duplex Doppler evaluation of the deep veins of the thigh and calf as described previously (18)(19)(20)(21)(22)(23). The studies were performed by experienced sonographers, and all scans were reviewed by attending radiologists with special expertise in US.…”

Principles of Examination of the Deep Veins in the Critically Ill

“…This structure is tubular on dynamic scanning, and not compressible using the Doppler hand, as opposed to the contralateral one. The letters labeling the bone shadows (P Fibula and T Tibia) are located at the level of the veins thrombosis can be isoechoic to the surrounding tissues [23], but the Carmen maneuver can usually recognize a tubular structure, even isoechoic, beside the artery.…”