COLOR-FLOW DUPLEX SCANNING IN SUSPECTED ACUTE DEEP-VEIN THROMBOSIS - EXPERIENCE WITH ROUTINE USE

Objectives: To determine the accuracy of colour flow Duplex scanning ( CFDS) in the diagnosis of deep vein thrombosis (DVT) and subsequently to investigate it diagnostic value in patients who have normal deep ve ins despite symptoms. Design: Prospective open clinical study. Setting : Vascular laboratory and radiology departments of University Hospital .Materials and Methods: In the first part 112 limbs in 103 patients, 9 4 with symptoms of acute DVT and nine with pulmonary embolism (PE) wer e examined prospectively with CFDS and venography. Subsequently, in th e second part, 328 legs in 304 patients were examined by CFDS alone fo rm acute symptoms of DVT or PE. Main Results: DVT was detected in 5 li mbs by venography: proximal DVT was seen in 23 limbs, distal DVT in 25 limbs and both proximal adn distal in seven limbs. CFDS was 100% sens itive and 98.8% specific in detecting proximal DVT whereas its sensiti vity and specificity was 87.5% and 98.7% for distal DVT. Positive and negative predictive values were over 95% for both limb segments. The o verall accuracy for the proximal DVT was 99.4% and for the distal 93.1 %. In the second part, CFDS alone detected DVT in 156 limbs (47.6%); D VT was in the proximal segment in 82, distal segment in 61 and both in 13. In 172 limbs other causes of symptoms were identified in 34 (20%) . Conclusions: We have demonstrated that CFDS is as accurate as venogr aphy when used by experienced operators. The average time of examinati ons is 15-20 minutes and compares favourably with venography. Other ca uses of leg symptoms can also be diagnosed by CFDS in around 20% of pa tients who are found to have normal veins.