Venous duplex imaging: should it replace hemodynamic tests for deep venous thrombosis?

The noninvasive diagnosis of deep vein thrombosis (DVT) has relied on detection of alterations in blood flow in the affected area. Phleborheography is one of the most sensitive tests; however, it cannot identify all thrombi (clots blocking blood flow). A new technique called venous duplex imaging (VDI) has been studied and is being rapidly accepted as a method to identify thrombi. The role of this test as an alternative to other methods is reviewed. Patient selection is important for assessing the capability of hemodynamic tests for DVT. One hundred and three patients with possible DVT were evaluated. Overall sensitivity and the sensitivity of detecting above-the-knee thrombi were significantly different between the two noninvasive tests used. VDI was significantly more sensitive in detecting both above-the-knee and below-the-knee thrombi than phlebography. VDI detected smaller clots that were missed by ascending phlebography. This non-invasive technique can thus replace hemodynamic tests for detection of DVT and may become the new diagnostic standard for deep venous thrombosis. (Consumer Summary produced by Reliance Medical Information, Inc.)