Diagnosis of deep vein thrombosis.
Deep vein thrombosis (DVT) requires a prompt and accurate diagnosis to avoid the potentially fatal consequences of a delay in adequate treatment. The diagnostic strategy of suspected venous thromboembolism is an example of the application of Bayes' theorem. As a result, the available diagnostic tools, both noninvasive (such as ultrasonography, D-dimer, and computed tomography) and invasive (such as venography), are usually integrated in diagnostic strategies that require the evaluation of the a priori clinical probability of disease (pretest probability). These strategies also vary according to the patient characteristics that allow the definition of five different categories: symptomatic outpatients, symptomatic inpatients, high-risk asymptomatic subjects, patients with suspected recurrence, and pregnant women. Some areas are still a matter of debate, such as the clinical relevance of isolated distal DVT and the diagnosis of suspected ipsilateral recurrence.
Palareti
Gualtiero
G
Department of Angiology and Blood Coagulation, University Hospital Saint Orsola-Malpighi, Bologna, Italy. palareti@tin.it
Cosmi
Benilde
B
Legnani
Cristina
C
D001499:Bayes Theorem; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010690:Phlebography; D010992:Plethysmography, Impedance; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D011336:Probability; D012008:Recurrence; D012307:Risk Factors; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D