Compression ultrasonography of the leg veins in patients with clinically suspected pulmonary embolism - Is a more extensive assessment of compressibility useful?

We performed a multi-center study in consecutive patients with suspected pu lmonary embolism to compare the diagnostic accuracy of a two-point compress ion ultrasonography (only the common femoral vein and popliteal vein) with an extensive examination of compressibility (from the common femoral vein u ntil the trifurcation of calf veins). A total of 479 patients underwent the two-point compression ultrasonography. The prevalence of pulmonary embolis m was 32%. The sensitivity and specificity of this procedure were 23% (95% CI 19-26) and 98% (95% CI 96-99), respectively. Extensive compression ultra sonography was performed in 461 (96%) of these 479 patients and showed comp arable accuracy indices (sensitivity 25%, 95% CI 20-28 and specificity 97%, 95% CI 95-99). We conclude that compression ultrasonography has a limited sensitivity for the detection of thrombosis in patients with acute pulmonar y embolism within 24 h of presentation. A more extensive assessment of comp ressibility of the leg veins in these patients has no additional value as c ompared to the two-point assessment.