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Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
Online ISSN 1827-1839
Baumgartner I., Braunschweig M., Triller J., Mahler F.
From the Department of Medicine, Division of Angiology (I.B., F.M.) and Department of Radiology (M.B., J.T.), University Hospital, Freiburgstrasse, Bern, Switzerland
Background. Power-based colour coded duplex sonography (PD) has been described to display lower flow velocities compared to frequency-based colour coded duplex sonography (CD). This study was undertaken to study the clinical usefulness of PD in the evaluation of calf veins in suspected deep vein thrombosis.
Methods. Experimental design: A prospective, comparative study. Setting: University hospital, Switzerland. Patients and Measures: CD of the complete deep venous system and complementary PD of paired calf veins were performed in 50 consecutive patients with clinically suspected DVT. All except three patients, with failed vein puncture at the dorsum of the foot, had a venography used as reference test for confirmatory diagnosis of DVT.
Results. Complete identification of calf veins increased from 80.5% using CD to 97.9% using complementary PD (p=0.007). Overall accuracy to detect an acute calf DVT was 96% (95% Ci, 85-99%) and 95% (95% CI, 83-99%), respectively. Accuracy was 95% (95% CI, 83-99%) using CD vs 94% (95% CI, 82-98%) using PD in posterior tibial, 87% (95% CI, 74-95%) vs 85% (95% CI, 71-94%) in anterior tibial, and 95% (95% CI, 83-99%) vs 96% (95% CI, 85-99%) in peroneal veins. Chronic postthrombotic changes (10.6%) were more reliably recognized using CD (accuracy 83% [95% CI, 72-94%]) compared to PD (accuracy 66% [95% CI, 59-85%]) due to tissue motion artifacts and inability to discriminate the direction of blood flow.
Conclusions. PD used complementary with CD is capable of significantly improving identification of paired calf veins without loss of diagnostic accuracy in the diagnosis of acute DVT.