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[A nation-wide survey: striking differences in the diagnostic procedures relating to thrombosis]
Ola Björgell1, Helle Kieler, Karin Hedenmalm
1Röntgendiagnostiska avdelningen, Universitetssjukhuset MAS, Malmö. ola.bjorgell@rontgen.mas.lu.se
Insights
Nearly 40,000 deep venous thrombosis (DVT) examinations occurred in Sweden in 2001. Phlebography included calf veins more often than Doppler sonography, and ambiguous cases often combined both methods.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Medical Diagnostics
Background:
- Deep venous thrombosis (DVT) is a significant vascular condition requiring accurate diagnosis.
- Diagnostic imaging techniques, including phlebography and Doppler sonography, are crucial for DVT assessment.
- Variations in diagnostic approaches can impact the accuracy and efficiency of DVT detection.
Purpose of the Study:
- To analyze the diagnostic practices for clinically suspected deep venous thrombosis (DVT) in Sweden in 2001.
- To compare the utilization and scope of phlebography versus Doppler sonography in DVT diagnosis.
- To evaluate the management of negative Doppler sonography results and the use of combined imaging modalities.
Main Methods:
- A national questionnaire survey was conducted in Sweden in 2001.
- Data collected focused on the number of DVT examinations, imaging modalities used, and interpretation protocols.
- Specific attention was paid to the inclusion of calf deep muscle veins and the management of ambiguous findings.
Main Results:
- Approximately 40,000 DVT examinations were performed, with phlebography slightly more common than Doppler sonography (CDU).
- Phlebography included calf deep muscle veins in two-thirds of cases, compared to less than one-fifth for CDU.
- Negative CDU results often precluded further investigation, while ambiguous cases frequently utilized a combination of CDU and phlebography.
Conclusions:
- Diagnostic strategies for DVT in Sweden in 2001 showed variability in imaging technique and scope.
- The routine use of combined CDU and phlebography for ambiguous cases suggests a pragmatic approach to improve diagnostic certainty.
- Standardization of imaging protocols, particularly regarding calf vein assessment, may enhance DVT diagnosis efficiency.
Abstract:
A questionnaire revealed that nearly 40 000 examinations of clinically suspected deep venous thrombosis (DVT) were performed in Sweden in 2001, with a slight predominance of phlebographies. In about two thirds of all cases the deep muscle veins of the calf were included in the interpretation when phlebography was performed, but in less than one fifth when Doppler sonography (CDU) was used. In more than half of the cases a negative CDU was not followed by phlebograghy. On the other hand, the combination of CDU and phlebography was routinely used in nearly two thirds of all ambiguous cases. The interpretation of nonfiling of contrast medium in vein segments on phlebography varied from DVT to no DVT. Most of the phlebographies were performed with digital X-ray technique.