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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
Does the asymptomatic limb harbor deep venous thrombosis?
J M Lohr1, K A Hasselfeld, M P Byrne
1John J. Cranley Vascular Laboratory, Good Samaritan Hospital, Cincinnati, Ohio 45220.
American Journal of Surgery
|August 1, 1994
Summary
Deep venous thrombosis (DVT) often presents without clear predictors. Bilateral lower extremity ultrasound is recommended for suspected DVT, as symptoms and risk factors are unreliable for diagnosis.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Medical Diagnostics
Background:
- Deep venous thrombosis (DVT) is a challenging condition due to its often asymptomatic nature and lack of reliable predictive clinical factors.
- Symptoms, patient history, and known risk factors are insufficient to accurately predict the presence of DVT.
- The diagnostic approach for DVT requires careful consideration due to its potential for misdiagnosis.
Purpose of the Study:
- To evaluate the utility of unilateral lower extremity duplex ultrasonography in diagnosing deep venous thrombosis (DVT).
- To identify specific patient populations or clinical scenarios where a unilateral DVT study might be appropriate.
- To determine if clinical presentation or risk factors can reliably predict DVT in affected individuals.
Main Methods:
- Bilateral lower extremity duplex ultrasonography scans were performed on 2,511 patients suspected of having DVT.
- Data on patient symptoms, affected limb laterality, and risk factors were collected and analyzed.
- Logistic regression analysis was employed to assess the predictive value of clinical variables for DVT.
Main Results:
- Deep venous thrombosis (DVT) was diagnosed in 43% of patients (1,086/2,511), with 30% unilateral and 14% bilateral.
- In patients with recorded symptoms, 64% had symptoms on the side with DVT, while 36% had symptoms on the contralateral side.
- DVT was found in 35% of asymptomatic lower extremities (128/362), and in an additional 263 patients, clots were present in asymptomatic limbs with a symptomatic contralateral limb.
- Logistic regression analysis failed to identify reliable combinations of symptoms and risk factors for predicting DVT.
Conclusions:
- Clinical presentation and risk factors are not reliable indicators for diagnosing deep venous thrombosis (DVT).
- A significant proportion of DVT cases occur in asymptomatic limbs or present with contralateral symptoms.
- Bilateral lower extremity duplex ultrasonography is the recommended diagnostic imaging modality when DVT is suspected.
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