Sandler DA, Martin JF, Duncan JS, Blake GM, Ward P, Ramsay LE, Lamont AC, Ross B, Sherriff S, Walton L. Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram.
Lancet 1984;
2:716-9. [PMID:
6148472 DOI:
10.1016/s0140-6736(84)92625-4]
[Citation(s) in RCA: 73] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the least accurate method. Impedance plethysmography, venoscan, and ultrasound had accuracies of 65%, 80%, and 82%, respectively. The initial X-ray venogram report had an accuracy of 90% compared with the interpretation of two experienced radiologists. The venoscan was equivocal in 32% of patients, and in the remaining patients the accuracy was 97%. Objective methods of investigation are essential for diagnosing deep-vein thrombosis. Of those tested, the X-ray venogram was the only investigation suitable for definitive diagnosis. The venoscan may have a role as a screening procedure, to be followed by X-ray venography in patients with equivocal venoscan results.
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