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. 1999 Nov;68(2):59–63.

Early experience using duplex ultrasonography in the diagnosis of deep venous thrombosis; a prospective evaluation.

P T Kennedy 1, W Loan 1, M Buckley 1, P Rice 1, P Hanley 1
PMCID: PMC2449110  PMID: 10661629

Abstract

Duplex ultrasound is used in many radiology departments as the first line of investigation for symptomatic deep venous thrombosis. Before changing the practice of our department from venography to duplex ultrasonography, we wanted to assess our ability to identify deep venous thrombosis on ultrasound. Thirty-eight patients were investigated for suspected deep venous thrombosis by venography and duplex ultrasound. The results were compared using venography as the 'gold standard'. Duplex ultrasound correctly identified 13 out of 16 limbs with deep venous thrombosis. Four of the 38 duplex ultrasound examinations (11%) were described as inadequate at the time of examination, and when these are excluded from the analysis a sensitivity of 93 %, and specificity of 80 % are achieved. We conclude that there is a significant learning curve when performing duplex ultrasound of the lower limb, and that change-over from venography to ultrasound should include a period during which both examinations are routinely performed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baxter G. M., Duffy P., Partridge E. Colour flow imaging of calf vein thrombosis. Clin Radiol. 1992 Sep;46(3):198–201. doi: 10.1016/s0009-9260(05)80445-3. [DOI] [PubMed] [Google Scholar]
  2. Becker D., Günter E., Strauss R., Cidlinsky K., Tomandl B., Kalden-Nemeth D., Neureiter D., Lang W., Hahn E. G. Color Doppler imaging versus phlebography in the diagnosis of deep leg and pelvic vein thrombosis. J Ultrasound Med. 1997 Jan;16(1):31–37. doi: 10.7863/jum.1997.16.1.31. [DOI] [PubMed] [Google Scholar]
  3. Bradley M. J., Spencer P. A., Alexander L., Milner G. R. Colour flow mapping in the diagnosis of the calf deep vein thrombosis. Clin Radiol. 1993 Jun;47(6):399–402. doi: 10.1016/s0009-9260(05)81060-8. [DOI] [PubMed] [Google Scholar]
  4. Burn P. R., Blunt D. M., Sansom H. E., Phelan M. S. The radiological investigation of suspected lower limb deep vein thrombosis. Clin Radiol. 1997 Aug;52(8):625–628. doi: 10.1016/s0009-9260(97)80257-7. [DOI] [PubMed] [Google Scholar]
  5. Cogo A., Lensing A. W., Prandoni P., Hirsh J. Distribution of thrombosis in patients with symptomatic deep vein thrombosis. Implications for simplifying the diagnostic process with compression ultrasound. Arch Intern Med. 1993 Dec 27;153(24):2777–2780. [PubMed] [Google Scholar]
  6. Comerota A. J., Katz M. L., Greenwald L. L., Leefmans E., Czeredarczuk M., White J. V. Venous duplex imaging: should it replace hemodynamic tests for deep venous thrombosis? J Vasc Surg. 1990 Jan;11(1):53–61. doi: 10.1067/mva.1990.16342. [DOI] [PubMed] [Google Scholar]
  7. Dauzat M., Laroche J. P., Deklunder G., Ayoub J., Quére I., Lopez F. M., Janbon C. Diagnosis of acute lower limb deep venous thrombosis with ultrasound: trends and controversies. J Clin Ultrasound. 1997 Sep;25(7):343–358. doi: 10.1002/(sici)1097-0096(199709)25:7<343::aid-jcu1>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  8. Giannoukas A. D., Labropoulos N., Burke P., Katsamouris A., Nicolaides A. N. Calf deep venous thrombosis: a review of the literature. Eur J Vasc Endovasc Surg. 1995 Nov;10(4):398–404. doi: 10.1016/s1078-5884(05)80161-3. [DOI] [PubMed] [Google Scholar]
  9. Labropoulos N., Leon M., Kalodiki E., al Kutoubi A., Chan P., Nicolaides A. N. Colour flow duplex scanning in suspected acute deep vein thrombosis; experience with routine use. Eur J Vasc Endovasc Surg. 1995 Jan;9(1):49–52. doi: 10.1016/s1078-5884(05)80224-2. [DOI] [PubMed] [Google Scholar]
  10. Langsfeld M., Matteson B., Johnson W., Wascher D., Goodnough J., Weinstein E. Baker's cysts mimicking the symptoms of deep vein thrombosis: diagnosis with venous duplex scanning. J Vasc Surg. 1997 Apr;25(4):658–662. doi: 10.1016/s0741-5214(97)70292-1. [DOI] [PubMed] [Google Scholar]
  11. Lohr J. M., Kerr T. M., Lutter K. S., Cranley R. D., Spirtoff K., Cranley J. J. Lower extremity calf thrombosis: to treat or not to treat? J Vasc Surg. 1991 Nov;14(5):618–623. doi: 10.1067/mva.1991.33057. [DOI] [PubMed] [Google Scholar]
  12. Mattos M. A., Melendres G., Sumner D. S., Hood D. B., Barkmeier L. D., Hodgson K. J., Ramsey D. E. Prevalence and distribution of calf vein thrombosis in patients with symptomatic deep venous thrombosis: a color-flow duplex study. J Vasc Surg. 1996 Nov;24(5):738–744. doi: 10.1016/s0741-5214(96)70006-x. [DOI] [PubMed] [Google Scholar]
  13. Miller N., Satin R., Tousignant L., Sheiner N. M. A prospective study comparing duplex scan and venography for diagnosis of lower-extremity deep vein thrombosis. Cardiovasc Surg. 1996 Aug;4(4):505–508. doi: 10.1016/0967-2109(95)00148-4. [DOI] [PubMed] [Google Scholar]
  14. Rose S. C., Zwiebel W. J., Nelson B. D., Priest D. L., Knighton R. A., Brown J. W., Lawrence P. F., Stults B. M., Reading J. C., Miller F. J. Symptomatic lower extremity deep venous thrombosis: accuracy, limitations, and role of color duplex flow imaging in diagnosis. Radiology. 1990 Jun;175(3):639–644. doi: 10.1148/radiology.175.3.2188293. [DOI] [PubMed] [Google Scholar]
  15. Sandler D. A., Martin J. F., Duncan J. S., Blake G. M., Ward P., Ramsay L. E., Lamont A. C., Ross B., Sherriff S., Walton L. Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram. Lancet. 1984 Sep 29;2(8405):716–719. doi: 10.1016/s0140-6736(84)92625-4. [DOI] [PubMed] [Google Scholar]
  16. Screaton N. J., Gillard J. H., Berman L. H., Kemp P. M. Duplicated superficial femoral veins: a source of error in the sonographic investigation of deep vein thrombosis. Radiology. 1998 Feb;206(2):397–401. doi: 10.1148/radiology.206.2.9457192. [DOI] [PubMed] [Google Scholar]

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