Purpose
Deep vein thrombosis (DVT) is an important cause of morbidity and mortality. B-mode and color doppler ultrasound (CDU) are highly accurate in its diagnosis. However, there are some diagnostic difficulties in patients that are obese or have soft tissue swelling. Moreover the accuracy of the method in diagnosis of deep calf vein thrombosis depends mostly on the possibility of satisfactory CDU imaging. The purpose of this study was to determine whether intravenous use of Levovist can improve the diagnostic valueof the method by reducing the...
Methods and Materials
Sixty patients with clinical suspicion of lower limb DVT were examined sonographically with and without the use of Levovist. Suspicion of this clinical entity was based on patients clinical symptoms and risk factors. Most frequent symptoms were pain, swelling, fever and clinical signs were tenderness, redness, local heat, edema and prominent superficial veins. Most frequent predisposing factors were prolonged bed rest and recent surgery. Asymptomatic patients, who were examined with CDU with sole criterion predisposing factors, were excluded from the study. Indeterminate scans led to...
Results
Cases classified, as patients with non-enhanced CDU were 26, while classified DVT free were 24. True positive diagnoses were 25 and the true negatives were 20. In 10 patients the result of CDU without Levovist was considered as indeterminate. Among them,4 patients were finally found to suffer from DVT and6 were not. The use of contrast medium resulted in 31 positive diagnosis and 26 negative. Among them 30 were true positive and 24 true negative. Exams in which positive or negative diagnosis could not be...
Conclusion
Color doppler sonography is highly accurate for the diagnosis of deep vein thrombosis in symptomatic patients. The use of SHU 508A improves the quality of color doppler examination especially in indeterminate cases. This results in increasing parameters of diagnostic value of the method. In cases with strong clinical suspicion of DVT and negative initial CDU assessment the use of contrast medium may be helpful, adding little diagnostic information.
References
Scharz K.Q., Becher H., Schimpfky C. et al. Doppler enhancement with SHU 508A in multiple vascular regions. Radiology 193:195,1994. Mattos A.M., Melendres G., Summer D.S., et al: Prevalence and distribution of calf vein thrombosis in patients with symptomatic DVT: A color-flow duplex study.J Vasc Surg 24; 738,1996. Bucec R.A., Kos T.,Schober E.,et al : Ultrasound with levovist in the diagnosis of suspected calf vein thrombosis. Ultrasound Med Biol 2001 Apr; 27(4):455-60. Baxter G.M., McKechnie S., Duffy P.: Colour Doppler Ultrasound in deep vein thrombosis: a...
Personal Information
P. S. Brestas (Athens/GR), A. Kotis (Rhodes/GR), L. Guidaglia (Rhodes/GR), O. Dafni (Athens/GR), E. Solounia (Rhodes/GR), C. Tsagari (Athens/GR), K. Giannaki (Rhodes/GR), N. Michalakis (Rhodes/GR)