Colour Doppler flow imaging ultrasonography versus venography as screening method for asymptomatic postoperative deep venous thrombosis.
OBJECTIVE
To evaluate colour Doppler flow imaging ultrasonography (CDFI), compared with venography, as a screening method for postoperative deep venous thrombosis (DVT) in a clinical trial on thromboprophylaxis.


METHODS
Patients undergoing major abdominal or thoracic surgery were prospectively screened for DVT by CDFI. Patients were examined preoperatively, and on post-operative days 1, 3, 7, 14, 21, and 28. When the CDFI was positive venography was performed. Bilateral venography was performed on day 28 in all patients. The study group comprised 82 patients who underwent CDFI and venography on the same day: four because of suspected DVT (positive CDFI), and 78 on day 28 according to protocol.


RESULTS
DVT was detected by venography in seven patients, in three of whom CDFI was positive. CDFI was falsely positive in one case. There were two popliteal and five calf DVTs, of which CDFI detected one and two, respectively. The sensitivity of CDFI was 43%, the specificity 99%. The PVpos for CDFI was 75%, and the PVneg 96%.


CONCLUSIONS
Due to low sensitivity, CDFI cannot stand alone as a screening method for asymptomatic postoperative DVT.
Lausen
I
I
Centre for Clinical Thrombosis Research, Bispebjerg Hospital, University of Copenhagen, Denmark.
Jensen
R
R
Wille-Jørgensen
P
P
Jørgensen
L N
LN
Rasmussen
M S
MS
Lyng
K M
KM
Andersen
M
M
Raaschou
H O
HO
D000005:Abdomen / Q000601:surgery; D001458:Bandages; D017558:Elective Surgical Procedures; D005268:Femoral Vein / Q000000981:diagnostic imaging; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply; D010690:Phlebography; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013903:Thoracic Surgery; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000517:prevention & control; D013927:Thrombosis / Q000000981:diagnostic imaging; D000078222:Tinzaparin; D018615:Ultrasonography, Doppler, Color; D014680:Veins
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin