[D-Dimer determination combined with clinical probability for the diagnosis of leg venous thrombosis].
OBJECTIVE
To evaluate the results of combination of D-Dimer test and simple clinical model for the diagnosis of deep vein thrombosis (DVT).


METHODS
Inclusion: clinical suspicion of DVT. Non inclusion criteria were Clinical model performed by the referring physician included probability varying from high to low. D-Dimer test was performed by five different rapid techniques. Standard of reference was Doppler ultrasonography (DU) performed by a senior radiologist.


RESULTS
Eight hundred and fifty-four DU were performed on a 14 months time period, including 206 suspicion of pulmonary embolism, 109 postoperative time period, 120 non-included or excluded patients, 278 incomplete observations, 141 complete observations. DVT was present in 33 cases and absent in the other 108 cases (prevalence 23%). Sensitivity and negative predictive value of the five tests were between 82 and 97% and 90 et 97%. The most sensitive test had a specificity of 36% and a positive predictive value of 32%. Combination of clinical model and D-Dimer test did not improve the diagnostic accuracy.


CONCLUSIONS
None of the test evaluated in the present study, even when combined with the clinical model results, did allow the exclusion of DVT.
Arrivé
L
L
Service de Radiologie, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75012 Paris. lionel.arrive@sat.ap-hop-paris.fr
Monnier-Cholley
L
L
Serru
V
V
Carrat
F
F
Vassal
T
T
Dahan
H
H
Bouras
T
T
Jomaah
N
N
Le Hir
P
P
Azizi
L
L
Belkacem
A
A
Lewin
M
M
Tubiana
J M
JM
Robert
A
A
D005573:Formycins / Q000097:blood*; D006801:Humans; D007866:Leg / Q000098:blood supply; D012265:Ribonucleotides / Q000097:blood*; D020246:Venous Thrombosis / Q000175:diagnosis*
D005573:Formycins; D012265:Ribonucleotides; C020332:formycin diphosphate