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Diagnosis of deep-vein thrombosis using an objective Doppler method
A W Lensing1, M M Levi, H R Büller
1Academic Medical Center, Amsterdam, The Netherlands.
Annals of Internal Medicine
|July 1, 1990
Summary
An objective Doppler-Valsalva pressure method accurately detects deep-leg-vein thrombosis in symptomatic outpatients. This reproducible and simple diagnostic tool aids in identifying venous thrombosis effectively.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Medical Technology
Background:
- Deep-leg-vein thrombosis (DLT) diagnosis in symptomatic outpatients often relies on clinical suspicion, necessitating accurate and efficient diagnostic methods.
- Contrast venography, while definitive, is invasive and carries risks, prompting the search for less invasive alternatives.
Purpose of the Study:
- To establish diagnostic criteria for an objective Doppler-Valsalva pressure method in phase I.
- To evaluate the diagnostic accuracy of this Doppler-Valsalva method compared to contrast venography in phase II for acute DLT.
Main Methods:
- A prospective, two-phase study involving consecutive outpatients with suspected venous thrombosis.
- Doppler ultrasound and Valsalva maneuver pressure measurements were correlated with contrast venography findings.
- Diagnostic criteria were established, and accuracy metrics (sensitivity, specificity) were calculated.
Main Results:
- The Doppler-Valsalva method demonstrated high diagnostic accuracy for proximal DLT in phase II.
- Sensitivity was 91% (95% CI, 79% to 98%) and specificity was 99% (CI, 97% to 100%).
- All cases of isolated calf-vein thrombosis were correctly identified as normal by the Doppler test.
Conclusions:
- The objective Doppler-Valsalva pressure method is a highly accurate, reproducible, and simple tool for diagnosing venous thrombosis.
- This non-invasive method offers a reliable alternative for the detection of DLT in symptomatic outpatients.
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