Deep vein thrombosis ultrasound
Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] ; Kashish Goel, M.D.; Assistant Editor(s)-In-Chief: Justine Cadet
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Overview
Venous ultrasound is the confirmatory test for diagnosis of DVT. The most common form is compression ultrasonography, which assesses the compressibility of femoral and popliteal veins. Diagnosis of DVT is established if the vein can not be collapsed under gentle ultrasound probe pressure. In most cases, it is performed in the proximal veins, as the risk of pulmonary embolism is much higher with that. Whole-leg ultrasound examines the deep veins of the proximal leg and calf, and it is used in cases where distal DVT is suspected. Iliac vein ultrasound may be performed, if thrombosis is suspected (e.g.: Pregnant women with swelling of the whole leg).
Compression Ultrasonography
Compression ultrasonography in B-mode has high sensitivity and specificity for detecting proximal deep vein thrombosis in symptomatic patients. The sensitivity lies somewhere between 90 to 100% for the diagnosis of symptomatic deep vein thrombosis, and the specificity ranges between 95 to 100%.
- Sensitivity
- Three months VTE rate with negative ultrasound is 0.57%
- Specificity
- It is one of the diagnostic tests for confirming the disease.
It is currently, the first-line imaging examination for DVT, because of the following reasons:
- Relative ease of use
- Absence of irradiation or contrast material
- High sensitivity and specificity
Ultrasound images demonstrate upper extremity deep vein thrombosis
Limitations
It has several limitations.
- As with impedance plethysmography, the results are limited in patients with deformities or a plaster cast.
- Isolated thrombi, present in the following locations, are not identified:
- In the iliac vein
- Femoral vein within the adductor canal.
- Serial studies may be needed, if the initial test is negative.
Video explaining Compression ultrasonography
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