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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


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 1999 December;18(4):287-93

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of near-infrared spectroscopy with air plethysmography in detection of deep vein thrombosis

Hosoi Y., Yasuhara H., Miyata T., Komiyama T., Onozuka A., Shigematsu H.

From the Division of Vascular Surgery, Department of Surgery, The University of Tokyo, Tokyo, Japan


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Background. As a non­in­va­sive screen­ing test, air ple­thys­mog­ra­phy (APG) is a reli­able and fre­quent­ly used modal­ity in the detec­tion of deep vein throm­bo­sis (DVT). Although APG is high­ly sen­si­tive for the diag­no­sis of prox­i­mal DVT, its sen­si­tiv­ity for iden­ti­fy­ing calf DVT is poor. Near-­infrared spec­tros­co­py (NIRS) is a new modal­ity which can be used to eval­u­ate ­venous reten­tion dur­ing walk­ing. The pur­pose of this study was to inves­ti­gate the diag­nos­tic value of NIRS for the detec­tion of DVT, par­tic­u­lar­ly iso­lat­ed calf DVT, in com­par­i­son with APG.
Methods. Fifty limbs of 39 con­sec­u­tive ­patients with clin­i­cal­ly sus­pect­ed DVT were stud­ied. All ­patients were exam­ined by venog­ra­phy and APG. Patients also under­went a tread­mill-walk­ing test with simul­ta­ne­ous NIRS. Deoxygenated hemo­glo­bin was con­tin­u­ous­ly meas­ured by NIRS dur­ing exer­cise. The ambu­la­to­ry ­venous reten­tion index ­obtained from seri­al DeoHb chang­es was cal­cu­lat­ed in each ­patient.
Results. Venography dem­on­strat­ed DVT in 35 limbs, con­fined to the calf in 9 limbs, and with the involve­ment of a prox­i­mal deep vein with throm­bi in 26. The over­all sen­si­tiv­ity of NIRS and APG was 97% (34/35) and 80% (28/35), respec­tive­ly. NIRS was more sen­si­tive than APG for detect­ing iso­lat­ed calf DVT (89% [8/9] and 22% [2/9], respec­tive­ly), while both tests iden­ti­fied prox­i­mal DVT in all limbs.
Conclusions. NIRS is a high­ly sen­si­tive meth­od for the diag­no­sis of hae­mod­y­nam­i­cal­ly sig­nif­i­cant DVT. NIRS may ­become a use­ful screen­ing test ­because of its reli­abil­ity in detect­ing calf vein throm­bi that cannot be iden­ti­fied by APG.

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