[Ultrasonographic diagnosis of venous thrombosis: color Doppler and power Doppler].
Eco color-Doppler (ECD) and Power Doppler (PD) currently allow an accurate and early diagnosis of deep venous thrombosis (DVT). "Ecocontrasts" boost sensitivity. The simple test of ultrasound probe compression shows excellent sensitivity in the proximal venous segments, comparable to a full ECD: the latter is preferable for distal segments. Ultrasound probe compression is not sufficient as the sole test when studying suspected leg DVT, but may form an integral part of a complete ECD study. The accuracy of ECD used in segments that are difficult to evaluate (iliac axes, inferior vena cava) has improved considerably thanks to PD. At these levels, it is certainly not possible to use ultrasound probe compression alone. The same is true for the diagnosis of recidivation, where a complete ECD is required to evaluate thrombotic overlap indicating true rethrombosis of partial or fully recanalised blood vessels. Phlebography no longer represents the gold standard for diagnosis compared to ultrasound techniques. Its use is limited to discriminating between genuinely doubtful and discordant cases of DVT and the search for occult embolic sources in patients with severe pulmonary embolism. The usefulness of an extensive study of venous vessels is gaining increasing confirmation, using the full potential of eco-Duplex methods in the systematic search for thrombotic lesions. The possibility of obtaining as much information as possible during the first complete scan reduces the costs of the procedure and is more accurate for the diagnosis of suspected DVT recidivation.
De Fabritiis
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Dipartimento Cardiovascolare, Unità Operativa di Angiologia, Sezione Malpighi, Policlinico S. Orsola-Malpighi, Bologna.
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D000925:Anticoagulants / Q000627:therapeutic use; D001132:Arm / Q000000981:diagnostic imaging; D003287:Contrast Media; D005268:Femoral Vein / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging; D007866:Leg / Q000000981:diagnostic imaging; D010690:Phlebography; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000188:drug therapy
D000925:Anticoagulants; D003287:Contrast Media