[Venous Doppler echography in acute pulmonary embolism].
In patients with clinically suspected pulmonary embolism, the signs and symptoms of venous thrombosis are late, insensitive and non specific. Detection of vein thrombosis requires more objective tests: (1) anatomical such as phlebography and ultrasonography which directly visualize the thrombus; the latter has the advantage of being non invasive and of providing a means to study extravascular structures as well as functional information, especially when combined with doppler velocimetry; (2) haemodynamic tests such as doppler and plethysmography which show impairment on venous return. These indirect tests are less reliable for detecting non occlusive and distal thrombi and are less specific than phlebography. Compared with phlebography, ultrasonic duplex scanning is very reliable and competitive for diagnosis and exact localization of the thrombosis, irrespective of its site (distal or proximal), its extent (isolated or extensive) and the degree of obstruction (partial or complete). However to be fully efficient, this technique must be performed by a trained specialist using specific equipment; it must always include doppler examination and explore the entire venous network. In addition, this technique makes it possible to explore the inferior and superior caval systems and the cardiac structures on the path of the migrating thrombus. Like phlebography, ultrasonography indicates venous thromboembolism only when it is positive; negative results do not exclude the diagnosis.
Elias
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Service de Cardiologie, CHU de La Timone, Marseille.
D000208:Acute Disease; D000792:Angiography; D006801:Humans; D008722:Methods; D010690:Phlebography; D010991:Plethysmography; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging; D014463:Ultrasonography
Exploration veineuse par échographie-Doppler dans l'embolie pulmonaire aiguë.