[Venous echo Doppler: a future standard test in the diagnosis of thrombosis of the lower limbs?].
Duplex ultrasound imaging provides both an ultrasound picture of the tissue being explored and the sound of the flow speed in a particular area. Colour Doppler imaging gives colour codes for the different flow rates. Venous pathology is always investigated, with ultrasound, on both sides, at the iliac and caval, femoral, and foreleg levels. For the latter, excellent equipment and patient position are required. Ultrasound criteria of deep venous thrombosis (DVT) are the incompressibility of the vein being investigated, and detection of the thrombosis with the ultrasound probe. Doppler criteria are asymmetric spontaneous flows, the loss of their respiratory rhythm, and the lack of flow induced by contraction of muscle. The colour Doppler draws provides the contours of a partial or floating thrombus. Compared with phlebography, ultrasound imaging has a sensitivity and specificity of 96%. Colour Doppler imaging is even more accurate: both sensitivity and specificity increase to 100%. The limitations of ultrasound are: its dependence on the investigator, the difficulty of making the diagnosis of recurring DVT when there already are previous sequellae, obesity, intra-abdominal gas, skin lesions or inflammatory oedema. Phlebography remains necessary in 5% of cases. The advantages of this technique are its non invasiveness, excellent diagnostic performance, low cost, and the possibility of diagnosing another cause, whether responsible for the clinical signs or not. It is indicated for the diagnosis of DVT, routine screening in patients at risk, and the early and late follow-up of patients. Today, ultrasound imaging should always be carried out before other investigations.(ABSTRACT TRUNCATED AT 250 WORDS)
Barrellier
M T
MT
Service d'Explorations Fonctionnelles, CHU Côte-de-Nacre, Caen.
D003663:Decision Trees; D006801:Humans; D010690:Phlebography; D013924:Thrombophlebitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography
Echo-doppler veineux: futur examen de référence dans le diagnostic des thromboses des membres inférieurs?