Paget-Schroetter disease echocardiography or ultrasound
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
- Paget-Schroetter disease is commonly diagnosed with a 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 requires 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.
- ↑ "Recurrent Upper Extremity Thrombosis Associated with Overactivity: A Case of Delayed Diagnosis of Paget-Schroetter Syndrome".