[Venous echography. What value should be attributes to a negative result?].
471 consecutive patients, suspected clinically of a deep venous thrombosis of the lower limbs, underwent two-level ultrasonography. The reliability of the method was assessed by phlebographic comparison in 185 of them (whenever ultrasonography was positive and in one case out of five when negative). Results were striking: 94 per cent sensitivity (100% by approximation) and 86 per cent specificity. The 286 patients who did not undergo phlebography and in whom ultrasonography was negative were followed up for a period of 1 to 12 months (mean: 7.2 months). 119 were not given anticoagulants and 167 were treated with Calciparine (subcutaneous calcium heparin) at the preventive dose 0.20 ml b.i.d. for 7 days. Only two cases of phlebitis were detected: one 9 days after the investigation and the other 8 months later, following exposure to a new thrombogenic risk. There were no fatal pulmonary emboli. No difference was found between the two groups. In total, two-level ultrasonography was shown to be reliable in comparison with phlebography but, above all, when the result was negative the absence of treatment had no untoward effect on the patient.
Bendayan
P
P
Service d'Angiologie, CHU Rangueil, Toulouse.
Boccalon
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D013924:Thrombophlebitis / Q000000981:diagnostic imaging*; D014463:Ultrasonography
Echographie veineuse. Quelle valeur accorder à un test négatif?