[Color-coded duplex ultrasonography compared to phlebography in deep leg and pelvic vein thrombosis]

Area of Science:

• Vascular Medicine
• Diagnostic Imaging
• Medical Technology

Background:

• Deep venous thrombosis (DVT) is a significant vascular condition requiring accurate diagnosis.
• Phlebography is the traditional gold standard but is invasive.
• Advancements in ultrasound technology offer potential for less invasive diagnostic methods.

Purpose of the Study:

• To evaluate the diagnostic accuracy of colour duplex ultrasonography (CDU) using a slow-flow technique for deep venous thrombosis (DVT) in the lower extremities.
• To compare the efficacy of CDU with phlebography in diagnosing DVT and monitoring fibrinolytic therapy.

Main Methods:

• A prospective study involving 100 patients with suspected lower extremity DVT.
• Colour duplex ultrasonography (CDU) with a slow-flow technique was performed on multiple deep veins.
• CDU findings were compared against ascending phlebography results.

Main Results:

• CDU demonstrated high sensitivity and specificity across various venous segments, with values ranging from 95.4% to 100% for sensitivity and 95.5% to 100% for specificity.
• CDU results were identical to phlebography in patients undergoing fibrinolytic therapy.
• CDU proved superior to real-time B-mode imaging for follow-up of fibrinolytic treatment.

Conclusions:

• Colour duplex ultrasonography is a highly accurate and reliable diagnostic tool for deep venous thrombosis, comparable to phlebography for primary diagnosis and follow-up.
• CDU offers a valuable, less invasive alternative for DVT diagnosis and is particularly effective for monitoring treatment response.
• While phlebography provides comprehensive venous system documentation and post-thrombotic syndrome staging, CDU excels in real-time assessment and treatment monitoring.