[Can ultrasonic scanning replace phlebography in the diagnosis of deep thrombophlebitis of the leg?]

Until recently, phlebography with contrast agents has been the standard method for demonstration of deep venous thrombosis in the lower limb (DVT). In recent years, however, this has been replaced to an increasing extent by ultrasonic scanning. In contrast to radiographic examination, this method does not require injection of a contrast agent and it does not employ ionizing irradiation. The principle of ultrasonic scanning is that a normal vein may be compressed flat by means of slight pressure from the transducer whereas a vein filled with thrombi cannot be compressed. Ultrasonic examination is not (yet?) of diagnostic value in the leg but, more centrally, it is of the same diagnostic value as radiographic examination. It is suggested that ultrasonic scanning can replace phlebography in patients with their first DVT. If this gives a negative result, it may possibly be supplemented by phlebography of the veins of the leg.