Diagnosing deep venous thrombosis in the 1990s.
Deep venous thrombosis is a common problem afflicting millions of Americans yearly and encountered by all clinicians regardless of specialty. Every imaging tool available to the radiologist has been used to make this sometimes elusive diagnosis. Contrast venography is widely used and respected as the gold standard for evaluating any venous disease. But it can be difficult to perform or poorly tolerated by the patient. Plethysmography, once the only alternative examination, is now practically nonexistant. It has been displaced by ultrasound, mainly due to its ease of performance and patient acceptance. Nuclear imaging has provided a series of screening tests such as the nuclear venogram, but new clot-specific monoclonal antibody tests are becoming available now. High technology imaging also has proven useful for problem solving. Computer tomography and digital subtraction techniques can be used to evaluate central veins or high flow areas. The newest technique, magnetic resonance imaging, can provide even more information than other tests and is already considered the examination of choice for the most difficult areas of the pelvis and neck. Understanding the strengths and weaknesses of these tests can help in choosing the best examination for each patient.
Brammer
W M
WM
Department of Radiology, Baptist Medical Center, Oklahoma City.
D006801:Humans; D008279:Magnetic Resonance Imaging; D010690:Phlebography; D010991:Plethysmography; D011877:Radionuclide Imaging; D013924:Thrombophlebitis / Q000175:diagnosis* / Q000000981:diagnostic imaging