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Limited B-mode venous imaging versus complete color-flow duplex venous scanning for detection of proximal deep venous
R Poppiti1, G Papanicolaou, S Perese
1Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033-4612, USA.
Purpose:
The purpose of this study was to compare the accuracy of a limited B-mode compression technique (BMCT) with a complete color-flow duplex venous examination (CDVE) for the detection of proximal deep vein thrombosis (DVT).
Methods:
We prospectively studied 72 patients (20 men and 52 women) for DVT. Two technologists blinded to each other performed either BMCT or CDVE independently. The BMCT is an abbreviated technique compressing two sites per limb. One site was the saphenofemoral junction including the superficial femoral and deep femoral vein confluence; the other was the saphenopopliteal junction including tibial vein confluence. Total limbs studied were 144. CDVE was considered the gold standard for purposes of sensitivity, specificity, and accuracy.
Results:
The technical failure rate of BMCT was three of 144. In all technically satisfactory examinations, the BMCT result was positive in 15 of 14 limbs, and the CDVE result was positive in 13. Sensitivity of BMCT was 100%, specificity was 98%, and overall accuracy was 99%. There were two false-positive results with BMCT; both were cases of popliteal veins deep to the artery leading to difficulty in compression. The BMCT was able to detect chronic thrombus, floating thrombus, and small thrombus behind femoral vein valve cusps.
Conclusion:
These data suggest that BMCT is a rapid, acceptable, alternative technique for detecting proximal DVT. In cases of equivocal or positive findings, the spectral and color-flow Doppler examination should be used to confirm the results.