The Value of Doppler Ultrasound in Patients with a Clinical Diagnosis of Deep Venous Thrombosis

1975 ◽  
Author(s):  
J. Meadway ◽  
A. N. Nicolaides
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Doppler Ultrasound ◽  
False Negative ◽  
Clinical Signs ◽  
Ultra Sound ◽  
Negative Results ◽  
Long Saphenous Vein ◽  
Before And After ◽  
Calf Compression

It has been suggested that Doppler ultrasound examination is useful in the diagnosis of deep venous thrombosis (DVT). The present study was undertaken to compare ultra sound with venography in 120 limbs of 106 patients who presented with clinical DVT or pulmonary embolism. A Parks 801 ultrasonic detector was used over the femoral and popliteal veins with calf compression before and after occlusion of the long saphenous vein at the knee.DVT was confirmed by venography in 44 limbs and was confined to the calf in 10 of these. Ultrasound detected 3 calf thromboses and 29 of 34 more extensive thromboses. The five failures with thrombus proximal to the calf were associated with partial occlusion (1) or extensive collateral circulation (4). Of the 76 limbs normal on venography 21 were thought to have DVT by ultrasound: these false positives could be attributed to oedema (11), haematoma (4), lymphocyst (1), injured muscle (1), cellulitis (1) or excessive tenderness (2) and were unexplained in 1. The results indicate that this test is more accurate than clinical signs alone, but users must be aware of its limitations, particularly the causes of false positive and false negative results.

Duplex investigations in children: Are clinical signs in children with venous disorders relevant?

2014 ◽  
Vol 30 (10) ◽  
pp. 719-723
Author(s):  
M Birgitte Maessen-Visch ◽  
L Smeets ◽  
C van Vleuten
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Varicose Veins ◽  
Clinical Signs ◽  
Patient Characteristics ◽  
Duplex Sonography ◽  
Chronic Venous Disease ◽  
Ultra Sound ◽  
Venous Disease ◽  
Venous Disorders

Objectives Ultra sound colored duplex sonography is the preferred method in diagnosing chronic venous disease. Data in children on incidence, indications, and results are lacking. Methods From the total of 9180 duplex investigations performed in our hospital from 2009 to 2012, data on indication and results of the investigation as well as patient characteristics were evaluated retrospectively for the proportion of pediatric patients. Results Duplex investigations were performed 49 times in 38 children (6–18 years), with an average of 1.3 times (1–6 times) per child. Forty percent showed abnormalities: 17 times deep venous thrombosis was suspected; deep venous thrombosis was objectified in 18%. In the 21 investigations performed for varicosis-related complaints, varicose veins or venous malformations were objectified in 57%. Edema was never a symptom of chronic venous disease. Conclusions Duplex investigation is not often performed in children. In children with established deep venous thrombosis, a family history with deep venous thrombosis is common. In general, edema was not seen in children with varicose veins and, therefore, does not seem a reliable clinical sign at young age.

The Clinical Diagnosis Of Deep Venous Thrombosis

1981 ◽  
Author(s):  
E Briët ◽  
M J Boekhout-Mussert ◽  
L H van Hulsteijn ◽  
C W Koch ◽  
H W C Loose ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Doppler Ultrasound ◽  
Clinical Examination ◽  
False Positive ◽  
False Negative ◽  
Diagnostic Strategies ◽  
Vein Thrombosis ◽  
Deep Vein

Fifty-three patients were examined because of suspected deep venous thrombosis, by means of clinical examination, Doppler ultrasound and venography. Eighty-two legs were examined with all three methods. Venography was positive in 40 and normal in 42. The clinical examination was false positive in 4 legs and false negative in 6. The Doppler ultrasound studies gave false positive results in 3 legs and false negative results in 6. These results are better than those reported in the literature probably because the thrombosis extended to the popliteal vein or the more proximal veins in 38 of the 40 legs with deep vein thrombosis. This high percentage of upper leg vein thrombosis can be explained by the fact that 47 of the 53 patients were ambulant when they developed the signs and symptoms of thrombosis. It is concluded, that the clinical examination and Doppler ultrasonography can be used to diagnose deep vein thrombosis in ambulant patients in our clinic. We presume that the findings reported in the literature cannot be used indiscriminately as a basis for diagnostic strategies in other hospitals because of widely varying categories of patients, referral patterns and diagnostic criteria that are virtually impossible to standardize.

scholarly journals Risk of deep venous thrombosis in elective neurosurgical procedures: a prospective, Doppler ultrasound–based study in children 12 years of age or younger

2017 ◽  
Vol 20 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Andrea G. Scherer ◽  
Ian K. White ◽  
Kashif A. Shaikh ◽  
Jodi L. Smith ◽  
Laurie L. Ackerman ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Doppler Ultrasound ◽  
Pediatric Patients ◽  
Ultrasound Examination ◽  
Neurosurgical Procedures ◽  
Clinical Trial Registration ◽  
Neurosurgical Patients ◽  
Before And After ◽  
Potential Risk Factors

OBJECTIVEThe risk of venous thromboembolism (VTE) from deep venous thrombosis (DVT) is significant in neurosurgical patients. VTE is considered a leading cause of preventable hospital deaths and preventing DVT is a closely monitored quality metric, often tied to accreditation, hospital ratings, and reimbursement. Adult protocols include prophylaxis with anticoagulant medications. Children’s hospitals may adopt adult protocols, although the incidence of DVT and the risk or efficacy of treatment is not well defined. The incidence of DVT in children is likely less than in adults, although there is very little prospectively collected information. Most consider the risk of DVT to be extremely low in children 12 years of age or younger. However, this consideration is based on tradition and retrospective reviews of trauma databases. In this study, the authors prospectively evaluated pediatric patients undergoing a variety of elective neurosurgical procedures and performed Doppler ultrasound studies before and after surgery.METHODSA total of 100 patients were prospectively enrolled in this study. All of the patients were between the ages of 1 month and 12 years and were undergoing elective neurosurgical procedures. The 91 patients who completed the protocol received a bilateral lower-extremity Doppler ultrasound examination within 48 hours prior to surgery. Patients did not receive either medical or mechanical DVT prophylaxis during or after surgery. The ultrasound examination was repeated within 72 hours after surgery. An independent, board-certified radiologist evaluated all sonograms. We prospectively collected data, including potential risk factors, details of surgery, and details of the clinical course. All patients were followed clinically for at least 1 year.RESULTSThere was no clinical or ultrasound evidence of DVT or VTE in any of the 91 patients. There was no clinical evidence of VTE in the 9 patients who did not complete the protocol.CONCLUSIONSIn this prospective study, no DVTs were found in 91 patients evaluated by ultrasound and 9 patients followed clinically. While the study is underpowered to give a definitive incidence, the data suggest that the risk of DVT and VTE is very low in children undergoing elective neurosurgical procedures. Prophylactic protocols designed for adults may not apply to pediatric patients.Clinical trial registration no.: NCT02037607 (clinicaltrials.gov)

Contact Thermography as a Screening Test for Deep Venous Thrombosis following Major Hip Surgery

1988 ◽  
Vol 29 (6) ◽  
pp. 649-652 ◽  
Author(s):  
L. Kjær ◽  
S. Winter Christensen ◽  
Aa. Vestergaard ◽  
A. Bjerg-Nielsen ◽  
P. Wille-Jørgensen
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
No Value ◽  
Screening Test ◽  
False Negative ◽  
Lower Limbs ◽  
Hip Surgery ◽  
Non Invasive ◽  
Negative Results ◽  
False Negative Results

Contact thermography is a non-invasive, easily handled, and inexpensive investigation for the diagnosis of deep venous thrombosis (DVT) in the lower limbs. In this study 56 patients with total hip replacement were screened for DVT by contact thermography, using bilateral ascending phlebography as reference procedure. Examinations were performed on the seventh postoperative day. All thermograms were evaluated blindly and independently at the end of the study. Phlebography revealed unilateral DVT in six patients. Only two had corresponding findings at thermography, giving four false negative results. Moreover, 14 false positive thermograms were found. Based on the number of legs investigated, the nosographic sensitivity and specificity thus were 33 and 87 per cent, respectively. It is concluded that contact thermography is of no value as a screening test for DVT following major hip surgery.

Triplex us in the diagnosis of asymptomatic deep venous thrombosis

1997 ◽  
Vol 38 (2) ◽  
pp. 327-331 ◽  
Author(s):  
M. Mantoni ◽  
C. Strandberg ◽  
K. Neergaard ◽  
C. Sloth ◽  
P. Seest Jørgensen ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
False Negative ◽  
Cost Effective ◽  
Negative Results ◽  
Asymptomatic Patients ◽  
False Negative Results ◽  
Risk Patients ◽  
Sonographic Screening ◽  
Calf Vein

Purpose: to evaluate the accuracy of triplex ultrasound (TUS) compared with venography as a screening test for deep venous thrombosis (DVT), and to evaluate interobserver variation in the interpretation of the venographic studies. Material and Methods: A total of 133 postoperative hip fracture patients, asymptomatic of DVT, were prospectively examined with TUS and venography. All venograms were reviewed blindly and in case of disagreement a consensus was arrived at. Results: the incidence of DVT was 20%, with isolated calf vein thrombi in 63% of the cases. There were 7 false-negative and one false-positive result/s at TUS, with a sensitivity of 74%, specificity of 99% and accuracy of 97%. the kappa values ranged from 0.58 to 0.82. the false-negative results were all caused by missed calf vein thrombi in technically inadequate examinations. at sonography 2% of vein segments were noninterpretable, compared to 29% at venography. Conclusion: Venous US is less sensitive as a test for DVT in this study of asymptomatic patients than in earlier studies on symptomatic patients. Still, sonographic screening of high-risk patients would be both effective and cost effective. Fresh thrombi may cause a false-negative compression test.

Contact Thermography, 99mTc-Plasmin Scintimetry and 99mTc-Plasmin Scintigraphy as Screening Methods for Deep Venous Thrombosis Following Major Hip Surgery

1987 ◽  
Vol 58 (03) ◽  
pp. 831-833 ◽  
Author(s):  
S Winter Christensen ◽  
P Wille-Jørgensen ◽  
L Kjær ◽  
C Stadeager ◽  
A Widding ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
No Value ◽  
False Negative ◽  
Hip Surgery ◽  
Screening Methods ◽  
Negative Results ◽  
False Negative Results ◽  
Screening Procedures ◽  
Sensitivity Specificity

SummaryFifty-six patients scheduled for total hip alloplasty were screened for deep venous thrombosis by means of 99mTc-plasmin scintimetry, 99mTc-plasmin scintigraphy and contact thermography. Investigations were performed on the seventh postoperative day, and a total of 112 legs were examined. Bilateral ascending phlebography was used as reference procedure, and the criteria for deep venous thrombosis were intraluminal filling defects at phlebography. Six patients developed unilateral deep venous thrombosis. All three screening procedures revealed many false positive and several false negative results. The nosographic sensitivity/specificity was 33%/75% for scintimetry, 50%/91% for scintigraphy and 33%/87% for contact thermography, respectively. It is concluded that all three tests are of no value as screening methods for deep venous thrombosis following major elective hip surgery.

COVID-19: how nuclear medicine can provide a differential diagnosis in very dubious case

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Maria Silvia De Feo ◽  
Viviana Frantellizzi ◽  
Giuseppe De Vincentis
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Ct Scan ◽  
Imaging Technique ◽  
False Negative ◽  
Clinical Signs ◽  
Negative Results ◽  
Infectious Disease Department ◽  
False Negative Results ◽  
99Mtc Hmpao

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

Risk factors of postthrombotic syndrome before and after deep venous thrombosis treatment

2016 ◽  
Vol 32 (6) ◽  
pp. 384-389 ◽  
Author(s):  
Rob HW Strijkers ◽  
Mark AF de Wolf ◽  
Cees HA Wittens
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Treatment Options ◽  
Postthrombotic Syndrome ◽  
Factor X ◽  
Catheter Directed Thrombolysis ◽  
Before And After ◽  
Patient Selection Criteria ◽  
The Moment

Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.

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