Deep vein thrombosis ultrasound

Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
Compression ultrasonography, as the name suggests combines ultrasonography of the deep veins with compressing the vein and hence called Compression ultrasonography. The technique can be used on deep veins of the upper and lower extremities. Some laboratories limit the examination, to the common femoral vein and the popliteal vein, whereas other laboratories examine the deep veins from the inguinal region to the calf veins.

Compression ultrasonography in B-mode has both high sensitivity and specificity for detecting proximal deep vein thrombosis in symptomatic patients. The sensitivity lies somewhere between 90 to 100% for the diagnosis of symptomatic deep vein thrombosis, and the specificity ranges between 95 to 100%.

It is the currently, the first-line imaging examination for DVT, because of the following reasons
 * Relative ease of use
 * Absence of irradiation or contrast material
 * High sensitivity and specificity.

Limitations
It has several limitations.
 * As with impedance plethysmography, the results are limited in patients with deformities or a plaster cast.
 * Isolated thrombi, present in the following locations, are not identified:
 * In the iliac vein
 * Femoral vein within the adductor canal.
 * Serial studies need to be performed when the initial test is negative