Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram.
In 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the least accurate method. Impedance plethysmography, venoscan, and ultrasound had accuracies of 65%, 80%, and 82%, respectively. The initial X-ray venogram report had an accuracy of 90% compared with the interpretation of two experienced radiologists. The venoscan was equivocal in 32% of patients, and in the remaining patients the accuracy was 97%. Objective methods of investigation are essential for diagnosing deep-vein thrombosis. Of those tested, the X-ray venogram was the only investigation suitable for definitive diagnosis. The venoscan may have a role as a screening procedure, to be followed by X-ray venography in patients with equivocal venoscan results.
D000293:Adolescent; D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D005268:Femoral Vein; D005340:Fibrinogen; D006801:Humans; D007084:Iliac Vein; D007866:Leg / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D010808:Physical Examination; D010992:Plethysmography, Impedance; D011152:Popliteal Vein; D013667:Technetium; D013848:Thigh / Q000033:anatomy & histology; D013924:Thrombophlebitis / Q000175:diagnosis*; D014463:Ultrasonography
D013667:Technetium; D005340:Fibrinogen