[Diagnosis of acute deep leg vein thrombosis with compression ultrasonography]

Abstract

We studied the accuracy of compression sonography in 238 patients suspected of deep venous thrombosis comparable to phlebography. The veins in the thigh were considered to be occluded when their lumen did not collapse under slight pressure with the scanner. In the lower leg, incompressible echosparse strings were regarded to be equivalent to thrombosed veins. Since in some patients both legs were submitted to phlebography, 301 x-ray-examinations of one leg were compared to ultrasound. 153 thromboses were detected by venography. Ultrasound diagnosis of venous occlusion was made with a sensitivity of 96% and a specificity of 99%. In 91% it was possible to predict the extent of the clot. Thigh vein thromboses were correctly seen with a sensitivity of 97% and a specificity of 99%. Isolated calf vein thromboses were detected with a sensitivity of 90% and a specificity of 99%. In 10% of the examinations ultrasound brought new essential information compared to phlebography. We conclude that compression sonography is an accurate method in the diagnosis of deep venous thrombosis and that it should be applied liberally in patients with suspected venous occlusions.