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

Between March 1990 and March 1991, in a prospective study, 100 patients (53 men, 47 women, median age 61.5 years) with suspected deep venous thrombosis of the lower extremities, colour duplex ultrasonography (CDU) (Ultramark 9, ATL) were investigated using the slow-flow technique. The CDU findings obtained for the external iliac vein (distal segment), the common femoral, the superficial femoral and popliteal veins, together with those of the veins of the lower extremity, were compared with the results of phlebography, which is considered to be the gold standard for this type of investigation. The sensitivity/specificity of CDU in diagnosing deep venous thrombosis was, from proximal to distal: 95.4%/100%, 100%/99%, 96.8%/97.1%, 98.5%/95.5% and 96.3%/98%. Fibrinolytic therapy (ultra high-dose short-term therapy: n = 16 patients; conventional fibrinolytic therapy: n = 4 patients) was indicated in 20 patients. In this group of patients identical results were obtained with CDU and ascending phlebography. Our experience shows CDU to be a supplementary diagnostic procedure to real-time B mode ultrasonic imaging in the establishment of the primary diagnosis, and to be superior to it in the follow-up evaluation of the results of fibrinolytic treatment. Both in the establishment of the primary diagnosis and follow-up of thrombosis of the deep leg and pelvic veins, CDU is the equal of phlebography. The advantage of the latter is in the documentation of the entire venous system and staging of post-thrombotic syndrome.