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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


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


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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