Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis.

Meadway, J.; An, Nicolaides; Walker, Cade; O'Connell, J

doi:10.1136/bmj.4.5996.552

Cited by 31 publications

(5 citation statements)

References 11 publications

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“…1,2 In addition to excellent overall performance, the examination does not involve radiation exposure or nephrotoxic contrast agents, can be performed portably, and is widely available. Despite the many advantages of duplex US for the identification of DVT, it is technically dependent on the experience of the individual performing and interpreting the procedure and can also be technically compromised by obesity, edema, or the presence of wounds or overlying bandages.…”

mentioning

confidence: 99%

18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

Rondina¹,

Lam²,

Pendleton³

et al. 2012

Clinical Nuclear Medicine

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Purpose 18F-FDG PET has been used for vascular disease, but its role in deep vein thrombosis (DVT) remains prospectively unexplored. Patients and Methods Whole-body 18F-FDG PET/CT scans were performed in patients 1 to 10 weeks after onset of symptomatic DVT (n = 12) and in control subjects without DVT (n = 24). The metabolic activity (SUVmax) of thrombosed and contralateral nonthrombosed vein segments was determined. The sensitivity and specificity of 18F-FDG PET/CT for the diagnosis of DVT were determined by receiver operating characteristic curve analyses. In 2 patients with DVT, changes in the metabolic activity of thrombosed vein segments in serial 18F-FDG PET scans. Results The metabolic activity in thrombosed veins [SUVmax, 2.41 (0.75)] was visually appreciable and significantly higher than in nonthrombosed veins in either the contralateral extremity of patients with DVT [SUVmax, 1.09 (0.25), P = 0.007] or control subjects [1.21 (0.22), P < 001]. The area under the receiver operating characteristic curve for SUVmax was 0.9773 (P < 001), indicating excellent accuracy. An SUVmax threshold of greater than 1.645 was 87.5% sensitive and 100% specific for DVT. Metabolic activity in thrombosed veins correlated significantly with time from DVT symptom onset (decrease in SUVmax of 0.02/d, P < 0.05). Best-fit-line analyses suggested that approximately 84 to 91 days after acute DVT, the maximum metabolic activity of thrombosed veins would return to normal levels. Conclusions 18F-FDG PET/CT is accurate for detecting acute symptomatic, proximal DVT. Metabolic activity in thrombosed veins decreases with time, suggesting that 18F-FDG PET may be helpful in assessing the age of the clot.

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mentioning

confidence: 99%

18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

Rondina¹,

Lam²,

Pendleton³

et al. 2012

Clinical Nuclear Medicine

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“…Nine studies correctly evaluated the accu racy of Doppler ultrasound for the diagnosis of symptomatic deep-vein thrombosis [78][79][80][81][82][83][84][85][86], albeit that subjective criteria for the anal ysis of flow sound were used, whereas the ear lier Doppler ultrasound studies had méthodo logie weaknesses [87][88][89], The pooled results of these studies demonstrated that Doppler ultrasound detected 280 of the 315 patients with venographically proven proximal-vein thrombosis, for a sensitivity of 89% (table 6). The test result was falsely abnormal in 93 of the 706 patients without proximal-vein thrombosis, for a specificity of 87%.…”

Section: Doppler Ultrasonographymentioning

confidence: 99%

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Cogo

Lensing²,

Wells³

et al. 1995

Pathophysiol Haemos Thromb

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Deep-vein thrombosis of the lower extremity is a frequent disorder associated with morbidity and mortality due to pulmonary embolism and the postthrombotic syndrome. It was not until the introduction of contrast venography that the inaccuracy of the clinical diagnosis became apparent. Since then, management decisions have usually been based on objective diagnostic test. Venography is generally considered the reference method for the diagnosis of deep-vein thrombosis, but it is invasive and associated with serious side effects. Several noninvasive or less invasive objective diagnostic methods have been developed. These diagnostic methods are distinctly different in technology and consequently in their ability to demonstrate or refute deep-vein thrombosis. In this review, a critical analysis is provided on the accurary of the current noninvasive diagnostic approaches to venous thrombosis in patients with a first episode of clinically suspected deep-vein thrombosis. Results of studies were considered only when their methodology fulfilled the essential criteria for evaluation of a diagnostic test.

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“…Our good results in this respect, despite the fact that our team 6ainly consists of physicians with very short angiologcal fraining (see under Methods), is probably related to the measurement of the venous stop-flow pressrlre. This very simple technique (L0) allows more reproducible results and reduces the subjectivity of this method which is underlined by other authors (17).…”

Section: Dandpmentioning

confidence: 83%

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

1982

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SummaryDoppler ultrasound flow examination, strain gauge plethysmography and contrast venography were performed in 160 lower limbs of 80 in-patients. Deep vein thrombosis (DVT) was suspected in 87 limbs. Using measurement of venous stop-flow pressure, the Doppler method had an overall sensitivity of 83%. By combined use of Doppler and Plethysmography, sensitivity was increased to 96%. Specificity was 62% and 51%, respectively. With a positive and a negative predictive value of 80% and 73%, respectively, the combination of both non-invasive methods cannot reliably replace venography in the diagnosis of DTV, although all (40/40) thromboses proximal to or involving the popliteal segment were detected by either Doppler and Plethysmography or both.After exclusion of 14 patients (18%) suffering from conditions known to alter the results of these non-invasive methods, the positive predictive value of abnormal findings in both Doppler and Plethysmography was increased to 94% for suspected limbs, whilst negative predictive value of both negative Doppler and Plethysmography was 90%, allowing the avoidance of venography in these patients.

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Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis.

Cited by 31 publications

References 11 publications

18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

18F-FDG PET in the Evaluation of Acuity of Deep Vein Thrombosis

Noninvasive Objective Tests for the Diagnosis of Clinically Suspected Deep-Vein Thrombosis

Diagnosis of Deep Vein Thrombosis by Combination of Doppler Ultrasound Flow Examination and Strain Gauge Plethysmography

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