Paget-Schroetter disease echocardiography or ultrasound: Difference between revisions
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** [[Sensitivity (tests)|Sensitivity]] of >80%<ref name="Rosa SalazarOtálora Valderrama20152">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref> | ** [[Sensitivity (tests)|Sensitivity]] of >80%<ref name="Rosa SalazarOtálora Valderrama20152">{{cite journal|last1=Rosa Salazar|first1=Vladimir|last2=Otálora Valderrama|first2=Sonia del Pilar|last3=Hernández Contreras|first3=María Encarnación|last4=García Pérez|first4=Bartolomé|last5=Arroyo Tristán|first5=Andrés del Amor|last6=García Méndez|first6=María del Mar|title=Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients|journal=Archivos de Bronconeumología (English Edition)|volume=51|issue=8|year=2015|pages=e41–e43|issn=15792129|doi=10.1016/j.arbr.2015.05.026}}</ref> | ||
** Non-invasive | ** Non-invasive | ||
* Based on some [[Randomized controlled trial|randomized trial]] [[duplex ultrasound]] has a [[Sensitivity (tests)|sensitivity]] of 78-100% and [[Specificity (tests)|Specificity]] of 82-100%. <ref name="IlligDoyle2010">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | * Based on some [[Randomized controlled trial|randomized trial]] [[duplex ultrasound]] has a [[Sensitivity (tests)|sensitivity]] of 78-100% and [[Specificity (tests)|Specificity]] of 82-100%. <ref name="IlligDoyle2010">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ||
* An experienced technician is able to distinguish between [[Acute (medicine)|acute]] and [[Chronic (medical)|chronic]] [[thrombus]] using [[Duplex ultrasound]]. An [[Acute (medicine)|acute]] [[thrombus]] which is echolucent leads to a non-compressible vein without any flow. In the contrary, a [[Chronic (medical)|chronic]] [[thrombus]] will appear [[Echogenicity|echogenic]] and fibrotic with notable collateral veins. <ref name="IlligDoyle20103">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | * An experienced technician is able to distinguish between [[Acute (medicine)|acute]] and [[Chronic (medical)|chronic]] [[thrombus]] using [[Duplex ultrasound]]. An [[Acute (medicine)|acute]] [[thrombus]] which is echolucent leads to a non-compressible vein without any flow. In the contrary, a [[Chronic (medical)|chronic]] [[thrombus]] will appear [[Echogenicity|echogenic]] and fibrotic with notable collateral veins. <ref name="IlligDoyle20103">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ||
* Some drawbacks of [[Duplex ultrasound|Duplex ultrasonography]] are: | * Some drawbacks of [[Duplex ultrasound|Duplex ultrasonography]] are: | ||
** Inadequate ability to picture the central parts of the [[Subclavian vein|Subclavian]] and [[Brachiocephalic vein|Innominate veins]] <ref name="IlligDoyle20104">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ** Inadequate ability to picture the central parts of the [[Subclavian vein|Subclavian]] and [[Brachiocephalic vein|Innominate veins]] <ref name="IlligDoyle20104">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ||
** Inadequate ability to distinguish central veins from an enlarged collateral vein<ref name="IlligDoyle20105">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ** Inadequate ability to distinguish central veins from an enlarged collateral vein<ref name="IlligDoyle20105">{{cite journal|last1=Illig|first1=Karl A.|last2=Doyle|first2=Adam J.|title=A comprehensive review of Paget-Schroetter syndrome|journal=Journal of Vascular Surgery|volume=51|issue=6|year=2010|pages=1538–1547|issn=07415214|doi=10.1016/j.jvs.2009.12.022}}</ref> | ||
** Highly technician dependent<ref name="Thompson20122">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ** Highly technician dependent<ref name="Thompson20122">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ||
** Findings could be affected by superimposed [[clavicle]] and deepness of [[Subclavian vein]] in the neck<ref name="Thompson2012">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ** Findings could be affected by superimposed [[clavicle]] and deepness of [[Subclavian vein]] in the neck<ref name="Thompson2012">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ||
** [[False negative|False negative rate]] of 30% (which makes [[Duplex ultrasound|Duplex ultrasonography]] an improper diagnostic tool to exclude the [[Paget-Schroetter disease]])<ref name="Thompson20123">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ** [[False negative|False negative rate]] of 30% (which makes [[Duplex ultrasound|Duplex ultrasonography]] an improper diagnostic tool to exclude the [[Paget-Schroetter disease]])<ref name="Thompson20123">{{cite journal|last1=Thompson|first1=Robert|title=Comprehensive Management of Subclavian Vein Effort Thrombosis|journal=Seminars in Interventional Radiology|volume=29|issue=01|year=2012|pages=044–051|issn=0739-9529|doi=10.1055/s-0032-1302451}}</ref> | ||
* [[Ultrasound]] as a non-invasive imaging could be used postoperatively to evaluate venous flow and caliber.<ref name="Rubin2009">{{cite journal|last1=Rubin|first1=Joseph|title=Invited Commentary|journal=The Annals of Thoracic Surgery|volume=87|issue=2|year=2009|pages=422|issn=00034975|doi=10.1016/j.athoracsur.2008.11.058}}</ref> | * [[Ultrasound]] as a non-invasive imaging could be used postoperatively to evaluate venous flow and caliber.<ref name="Rubin2009">{{cite journal|last1=Rubin|first1=Joseph|title=Invited Commentary|journal=The Annals of Thoracic Surgery|volume=87|issue=2|year=2009|pages=422|issn=00034975|doi=10.1016/j.athoracsur.2008.11.058}}</ref> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 22:32, 3 June 2020
Overview
- Paget-Schroetter disease is commonly diagnosed with history and physical examinations. However imaging is usually utilized to confirm the diagnose. Duplex ultrasound is an accepted initial test and the gold standard imaging of Paget-Schroetter disease. Since this diagnostic tool is not fully appropriate to exclude the Paget-Schroetter disease, normal Duplex ultrasound in a highly suspected patient require further investigations.
Ultrasound
- Duplex ultrasound is the gold standard method to diagnose Paget-Schroetter (effort thrombosis).[1]
- Doppler ultrasonography is the best initial test to evaluate a patient with suspected Paget-Schroetter disease (also known as Effort thrombosis).[2] There are some convenient features of this test that make it a proper initial imaging. These features include:
- Low cost [3]
- Availability
- Portability
- Specificity of 93%[4]
- Sensitivity of >80%[5]
- Non-invasive
- Based on some randomized trial duplex ultrasound has a sensitivity of 78-100% and Specificity of 82-100%. [6]
- An experienced technician is able to distinguish between acute and chronic thrombus using Duplex ultrasound. An acute thrombus which is echolucent leads to a non-compressible vein without any flow. In the contrary, a chronic thrombus will appear echogenic and fibrotic with notable collateral veins. [7]
- Some drawbacks of Duplex ultrasonography are:
- Inadequate ability to picture the central parts of the Subclavian and Innominate veins [8]
- Inadequate ability to distinguish central veins from an enlarged collateral vein[9]
- Highly technician dependent[10]
- Findings could be affected by superimposed clavicle and deepness of Subclavian vein in the neck[11]
- False negative rate of 30% (which makes Duplex ultrasonography an improper diagnostic tool to exclude the Paget-Schroetter disease)[12]
- Ultrasound as a non-invasive imaging could be used postoperatively to evaluate venous flow and caliber.[13]
References
- ↑ Hangge, Patrick; Rotellini-Coltvet, Lisa; Deipolyi, Amy R.; Albadawi, Hassan; Oklu, Rahmi (2017). "Paget-Schroetter syndrome: treatment of venous thrombosis and outcomes". Cardiovascular Diagnosis and Therapy. 7 (S3): S285–S290. doi:10.21037/cdt.2017.08.15. ISSN 2223-3652.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
- ↑ Rosa Salazar, Vladimir; Otálora Valderrama, Sonia del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés del Amor; García Méndez, María del Mar (2015). "Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients". Archivos de Bronconeumología (English Edition). 51 (8): e41–e43. doi:10.1016/j.arbr.2015.05.026. ISSN 1579-2129.
- ↑ Rosa Salazar, Vladimir; Otálora Valderrama, Sonia del Pilar; Hernández Contreras, María Encarnación; García Pérez, Bartolomé; Arroyo Tristán, Andrés del Amor; García Méndez, María del Mar (2015). "Multidisciplinary Management of Paget-Schroetter Syndrome. A Case Series of Eight Patients". Archivos de Bronconeumología (English Edition). 51 (8): e41–e43. doi:10.1016/j.arbr.2015.05.026. ISSN 1579-2129.
- ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
- ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
- ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
- ↑ Illig, Karl A.; Doyle, Adam J. (2010). "A comprehensive review of Paget-Schroetter syndrome". Journal of Vascular Surgery. 51 (6): 1538–1547. doi:10.1016/j.jvs.2009.12.022. ISSN 0741-5214.
- ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
- ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
- ↑ Thompson, Robert (2012). "Comprehensive Management of Subclavian Vein Effort Thrombosis". Seminars in Interventional Radiology. 29 (01): 044–051. doi:10.1055/s-0032-1302451. ISSN 0739-9529.
- ↑ Rubin, Joseph (2009). "Invited Commentary". The Annals of Thoracic Surgery. 87 (2): 422. doi:10.1016/j.athoracsur.2008.11.058. ISSN 0003-4975.