Doppler Ultrasound in the Diagnosis of Deep Venous Thrombosis

Doppler ultrasound was used to study 120 legs of 106 patients with suspected deep vein thrombosis (DVT) or pulmonary embolism 1. Venography was subsequently performed in all. DVT was confirmed by venography in 44 legs and was confined to the calf in 10 of these. Ultrasound detected three calf thromboses and 29 out of 34 more extensive thromboses (sensitivity 85%). Of the 76 limbs without venographic evidence of thrombosis 21 were thought to have DVT by ultrasound.

Doppler ultrasound, impedance plethysmography, and contrast venography were performed in 207 lower limbs suspected of deep venous thrombosis 2. Doppler ultrasound and impedance plethysmography correctly diagnosed 96% and 95% of normal limbs, respectively. In limbs with venographic evidence of thrombosis requiring treatment, Dopper ultrasound and impedance plethysmography had sensitivites of 60% and 97%, respectively.

Doppler ultrasonic examinations and contrast phlebography were performed on 55 limbs of 43 patients with a clinical diagnosis of venous thrombosis of the calf 3. There was diagnostic concurrence of Doppler and venographic evaluations in 46 of 55 limbs studied. There was only one instance of a false-negative diagnosis by Doppler examination.

Comment: The quality of evidence is downgraded by imprecise results, inconsistency (variability in results across studies), and study limitations.

References

• ^{Meadway J, Nicolaides AN, Walker CJ, O'Connell JD. Value of Doppler ultrasound in diagnosis of clinically suspected deep vein thrombosis. Br Med J 1975 Dec 6;4(5996):552-4. [PubMed]}
• Flanigan DP, Goodreau JJ, Burnham SJ, Bergan JJ, Yao JS. Vascular-laboratory diagnosis of clinically suspected acute deep-vein thrombosis. Lancet 1978 Aug 12;2(8085):331-4. [PubMed]
• Barnes RW, Russell HE, Wu KK, Hoak JC. Accuracy of Doppler ultrasound in clinically suspected venous thrombosis of the calf. Surg Gynecol Obstet 1976 Sep;143(3):425-8. [PubMed]