[Diagnosis of deep venous thrombosis of the lower limbs: performance of diagnostic tests].
Deep-vein thrombosis is a frequent affection that needs precise diagnosis. Indeed, the clinical complications (from post-thrombotic syndrome to fatal pulmonary embolism) as well the risk of anticoagulant treatment require a precise diagnosis. Since clinical evaluation cannot assure reliably diagnosis by lack of sensitivity and specificity, complementary exams are needed. However, clinical assessment is an important part to decide further examinations. D-dimers assessment allows to role out the diagnosis of deep-vein thrombosis in a number of cases. Plethysmography and continuous Doppler are progressively given up. Compressive venous ultrasonography is now the exam of first choice. Scintigraphy, scanner and RMI must still be validated. Phlebography remains the gold standard in case of negative compressive venous ultrasonography and a high clinical probability.
Merminod
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Division d'angiologie et d'hémostase, hôpital universitaire de Genève, rue Micheli-du-Crest 24, CH-1211 Genève 14, Suisse. thierry.merminod@hcuge.ch
de Moerloose
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D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D018810:Magnetic Resonance Angiography; D010690:Phlebography; D010992:Plethysmography, Impedance; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013924:Thrombophlebitis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D036542:Tomography, Spiral Computed; D018608:Ultrasonography, Doppler
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D