High-resolution real-time ultrasonography in the diagnosis of deep vein thrombosis

The contribution of high-resolution real-time ultrasonography to the diagnosis of deep vein thrombosis (DVT) was evaluated in a prospective study performed on 96 patients. 45 patients were also examined with contrast venography and 79 with continuous wave Doppler ultrasound. The femoral and popliteal veins were examined for compressibility by pressure with the transducer probe, response to deep inspiration and Valsalva's manoeuvre and presence of an intraluminal mass. The contralateral veins were routinely screened for comparison. The diagnostic sensitivity versus phlebography was 87%, and the specificity 100% for the femoral vein. When including the popliteal vein the specificity was 91%. Real-time ultrasonography together with Doppler ultrasound examination is an effective non-invasive approach for the diagnosis of DVT. Phlebography can be avoided if these two examinations are unequivocally positive or negative for DVT.