Added value of two-dimensional shear wave elastography to ultrasonography for staging common femoral vein thrombi.
prove the performance for staging common femoral vein thrombi (CFVT).


METHODS
A total of 194 consecutive patients with CFVT who underwent US and 2D-SWE were enrolled. These patients were categorized into three groups according to CFVT duration: Stage A (≤14 days), Stage B (14 days to 6 months), and Stage C (≥6 months). The diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC).


RESULTS
Among all US features, CFV diameter ratio of thrombosed leg to contralateral leg (CFVD_ratio) showed the highest AUC in predicting Stage A and Stage C (0.87 and 0.84, respectively). The diagnostic performance of 2D-SWE value of CFVT (CFVT_E) is comparable with that of CFVD_ratio for Stage A (AUC: 0.85, p=0.630), whereas inferior to that of CFVD_ratio for Stage C (AUC: 0.73, p=0.026). Combining CFVD_ratio with CFVT_E showed lower performance in predicting Stage A (AUC: 0.81, p=0.021) and Stage C (AUC: 0.67, p<0.0001) relative to CFVD_ratio alone. However, this combination increased the specificity from 80.3% to 92.7% (p<0.0001) without a significant reduction of sensitivity (from 77.2% to 70.2%, p=0.371) for predicting Stage A.


CONCLUSIONS
Adding 2D-SWE to US did not improve the diagnostic performance for staging CFVT compared with US alone. However, the combination improved the specificity in predicting CFVT less than 14 days without loss of sensitivity.
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Fu-Shun
FS
Pan
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Wen-Shuo
WS
Tian
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Jia
J
Luo
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Ming
M
Liu
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Jin-Yu
JY
Liang
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Ming
M
Xu
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China.
Yan-Ling
YL
Zheng
Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, P.R. China. xxy1992sys@163.com.
Xiao-Yan
XY
Xie
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*; D055815:Young Adult