Validation of color Doppler ultrasound and computed tomography in the radiologic assessment of non-malignant acute splanchnic vein thrombosis

Abstract

Introduction International guidelines propose color Doppler ultrasound (CDUS) and contrast-enhanced computed tomography (CT) as primary imaging techniques in the diagnosis of acute splanchnic vein thrombosis. However, their reliability in this context is poorly investigated. Therefore, the aim of our study was to validate CDUS and CT in the radiologic assessment of acute splanchnic vein thrombosis, using direct transjugular spleno-portography as gold standard. Materials and methods 49 patients with non-malignant acute splanchnic vein thrombosis were included in a retrospective, multicenter analysis. The thrombosis’ extent in five regions of the splanchnic venous system (right and left intrahepatic portal vein, main trunk of the portal vein, splenic vein, superior mesenteric vein) and the degree of thrombosis (patent, partial thrombosis, complete thrombosis) were assessed by portography, CDUS and CT in a blinded manner. Reliability of CDUS and CT with regard to portography as gold standard was analyzed by calculating Cohen’s kappa. Results Results of CDUS and CT were consistent with portography in 76.6% and 78.4% of examinations, respectively. Cohen’s kappa demonstrated that CDUS and CT delivered almost equally reliable results with regard to the portographic gold standard (k = 0.634 [p < 0.001] vs. k = 0.644 [p < 0.001]). In case of findings non-consistent with portography there was no clear trend to over- or underestimation of the degree of thrombosis in both CDUS (60.0% vs. 40.0%) and CT (59.5% vs. 40.5%). Conclusions CDUS and CT are equally reliable tools in the radiologic assessment of non-malignant acute splanchnic vein thrombosis.

Acute mesenteric ischemia secondary to oral contraceptive-induced portomesenteric and splenic vein thrombosis: A case report

“…On admission, our patient’s routine investigations showed a high white blood cell count and high hemoglobin and D-dimer levels. Additionally, she was a young woman taking oral contraceptives, who presented with acute severe abdominal pain not consistent with her physical examination findings according to the previous literature[ 13 , 20 ]. Accordingly, we suspected the possibility of AMI induced by MVT, and she was finally diagnosed with AMI induced by PMSVT.…”

“…The EASL Clinical Practice Guidelines[ 11 ] and AASLD Practice Guidelines[ 12 ] propose color Doppler sonography (CDUS) and CECT as the primary imaging techniques for diagnosing acute splanchnic vein thrombosis. Sturm et al [ 13 ] demonstrated that CDUS and CECT are equally reliable in assessing the grade and extent of acute splanchnic vein thrombosis[ 13 ]. The diagnostic sensitivity and specificity of CDUS in detecting PV thrombosis (PVT) vary from 66% to 100%[ 14 ].…”

Correlation analysis of Blood TM, TG and D-dimer with deep venous Thrombosis formation in patients after Total Hip Arthroplasty

“…DVT is characterized by occult onset and low diagnostic rate using conventional Doppler ultrasound, resulting in the lack of effective control of the occurrence of DVT. 4 Meanwhile, venography is costly and time-consuming, despite high diagnostic accuracy. 5 Consequently, it is important to determine a more convenient and efficient diagnostic mode.…”

“…DVT is characterized by occult onset and low diagnostic rate using conventional Doppler ultrasound, resulting in the lack of effective control of the occurrence of DVT. 4 …”

Identification of thrombotic biomarkers in orthopedic surgery patients by plasma proteomics

“…However, radiation exposure and expensive price restrict the application of the diagnosis [ 9 ]. Featuring with high sensitivity and accuracy, color Doppler ultrasound has been applied to the diagnosis of DVT [ 10 , 11 ]. However, the guiding value for clinical doctors to prevent thrombosis is limited.…”