DUPLEX ULTRASOUND SCANNING FOR DIAGNOSING LOWER-LIMB DEEP-VEIN THROMBOSIS

BACKGROUND. Traditionally, venography is used to investigate deep vein thrombosis (DVT) though duplex ultrasound offers a challenging, nonin vasive alternative method and previous reports have described the use of duplex ultrasound for detecting proximal lesions. OBJECTIVE. To com pare duplex ultrasound imaging with venography for both proximal and d istal lesions using the probe compression technique and a different pr otocol. METHODS. Duplex scans were done by the same operator prior and blind to venography, which was performed using a standard protocol wi th the films being reviewed blindly by a second radiologist at a later date. RESULTS. In 74 patients, 21 of 22 above-knee lesions present on venography were detected by duplex scanning and there was complete ag reement in the 52 of 52 venogram negatives. For lesions below the knee , duplex detected 26 of 27 lesions also present on venography and agre ed on 37 of 43 venogram negatives. These figures give duplex ultrasoun d overall accuracies of 99% and 90% (Kappa 98% and 89%) for above- and below-knee lesions, respectively. CONCLUSION. These figures suggest d uplex ultrasound technique compares favorably with venography for diag nosing both proximal and distal lesions.