Deep vein thrombosis ultrasound

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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

Deep Vein Thrombosis Microchapters

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Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Deep vein thrombosis from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Approach

Assessment of Clinical Probability and Risk Scores

Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings

Ultrasound

Venography

CT

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Other Imaging Findings

Treatment

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Future or Investigational Therapies

Special Scenario

Upper extremity DVT

Recurrence

Pregnancy

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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.

Video explaining Compression ultrasonography

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References

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