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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Published on: February 10, 2023

Diagnosis of venous thromboembolism in children

Christoph Male1, Stefan Kuhle, Lesley Mitchell

  • 1Children's Hospital University of Vienna, Vienna, Austria. c.male@akh-wien.ac.at

Seminars in Thrombosis and Hemostasis
|October 1, 2003
PubMed

Insights

Pediatric venous thromboembolic events (VTE) often link to central venous lines (CVL). Accurate diagnosis requires objective testing, as clinical signs are unreliable for these significant, often asymptomatic, conditions.

Area of Science:

  • Pediatric Medicine
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Venous thromboembolic events (VTE) in children are frequently associated with central venous lines (CVL).
  • CVL-related VTE commonly occur in the central upper venous system.
  • Many cases are asymptomatic or misdiagnosed due to underlying conditions, leading to potential complications.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of various imaging modalities for central venous line-related VTE in children.
  • To determine the optimal imaging strategy for detecting VTE in both upper and lower central venous systems.

Main Methods:

  • Review of diagnostic imaging techniques including ultrasound, venography, and magnetic resonance venography.
  • Assessment of sensitivity and specificity for detecting VTE in different venous segments.
  • Consideration of combined imaging approaches for comprehensive diagnosis.

Main Results:

  • Clinical diagnosis of CVL-related VTE is unreliable.
  • Ultrasound is insensitive for VTE in the central venous system; venography has limitations for jugular VTE.
  • A combination of ultrasound and venography is necessary for accurate diagnosis in the upper venous system.

Conclusions:

  • Objective radiographic screening is essential for diagnosing CVL-related VTE due to unreliable clinical presentation.
  • Combined ultrasound and venography are recommended for upper venous system VTE.
  • Magnetic resonance venography shows promise as a valid alternative for diagnosing VTE in both upper and lower central venous systems.

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