Ultrasound Elastography to Assess Age of Deep Vein Thrombosis: A Systematic Review

Abstract

Background and aims: Deep-vein thrombosis (DVT) is a widely diffused condition, and its accurate staging has major clinical and therapeutic implications. Ultrasound elastography (UE) is a rapidly evolving imaging technique that allows quantification of elastic tissue properties and could play a crucial role in determining thrombus age. The aim of this review is to find clinical evidence regarding the application of UE in the evaluation of DVT and its usefulness in differentiating thrombosis age. Methods: A literature search of clinical studies was performed to identify the ability of UE of discriminate acute, subacute, and chronic DVT. Heterogeneity and publication bias were calculated. In accordance with the study protocol, a qualitative analysis of the evidence was planned. The results were summarized with a comprehensive summary table of study characteristics and baseline characteristics of participant patients. Results: Nine studies matched the predetermined eligibility requirements for this systematic review regarding the risk of bias; the greatest criticalities were found within the domains of patient selection and index test. Based on the quality assessment, two publications were excluded from the qualitative synthesis because of the presence of significant applicability concerns. Among the seven studies that were considered eligible for qualitative synthesis, four evaluated strain elastography and three evaluated shear-wave elastography. Despite significant differences concerning study design, thrombus age definitions, and patient characteristics, nearly all studies demonstrated an increase in thrombus stiffness according to DVT age. Conclusions: UE could play a key role in routine ultrasound examination of DVT. The measurement of thrombus stiffness has a high biological plausibility and its use is supported by the finding of a correlation between the stiffness and the progression of the DVT age.

Safety and effectiveness of rehabilitation training for stroke complicated with muscular call vein thrombosis: An observational study

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The History of Diagnosing Venous Thromboembolism

“…Finally, various other imaging modalities such as 99mTc-recombinant tissue plasminogen activator scintigraphy imaging, 18 F-fluorodeoxyglucose positron emission tomography–computed tomography ( 18 F-FDG PET/CT), and US elastography have been developed for detecting acute thrombosis or to differentiate acute thrombosis from chronic thrombosis. 31 32 33 However, these radiological techniques have only been studied to a limited extent and have not found their way into clinical practice.…”

Effect of rt‐PA on Shear Wave Mechanical Assessment and Quantitative Ultrasound Properties of Blood Clot Kinetics In Vitro

“…An in vivo rabbit model study 27 could successfully separate acute from chronic thrombi with shear wave (SW) elastography. Such results have been less conclusive in humans 29–32 ; readers may consult a systematic review of clinical studies for details 33 . The clot's resistance to thrombolytics has also been related to its stiffness and mass density 23 .…”