Clinical application of sonographic elasticity imaging for aging of deep venous thrombosis: preliminary findings.
OBJECTIVE
Aging of deep venous thrombosis is an important and difficult clinical problem. Because it is known that thrombi harden as they mature, we have preliminarily tested sonographic elasticity imaging, a technique that estimates tissue hardness, to age venous thrombi.


METHODS
Two adult patients with lower extremity thrombi were studied. One had a clinically chronic thrombus (at least 3 years old), whereas the other patient's thrombus was clinically subacute (25 days old). We performed freehand compression sonographic scans using a 5-MHz linear array transducer. Phase-sensitive B-scan frames were processed offline by a two-dimensional complex correlation-based adaptive speckle-tracking technique. The distribution of internal strains in the wall of the vein, thrombus, and surrounding tissue was analyzed. Clot hardness was normalized to the venous wall.


RESULTS
The chronic clot was homogeneous, and the strain in the chronic clot was at least 10 times smaller than that in the vessel wall. The subacute clot was much more heterogeneous, and, on average, the strain magnitude in the clot was 3 to 4 times greater than that in the vessel wall.


CONCLUSIONS
In this preliminary work, the 2 thrombi appeared very different, and these results suggest that elasticity imaging may be able to age deep venous thrombosis.
Rubin
Jonathan M
JM
Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, USA. jrubin@umich.edu
Aglyamov
Salavat R
SR
Wakefield
Thomas W
TW
O'Donnell
Matthew
M
Emelianov
Stanislav Y
SY
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein / Q000000981:diagnostic imaging*; D012501:Saphenous Vein / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*