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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1998 March;17(1):43-8


language: English

Power-based colour coded duplex sonography for evaluation of calf veins

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.

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