Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram

TY - JOUR

T1 - Diagnosis of deep-vein thrombosis

T2 - comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram

AU - Sandler, D A

AU - Duncan, J S

AU - Ward, P

AU - Lamont, A C

AU - Sherriff, S

AU - Martin, J F

AU - Blake, G M

AU - Ramsay, L E

AU - Ross, B

AU - Walton, L

PY - 1984/9/29

Y1 - 1984/9/29

N2 - 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.

AB - 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.

U2 - 10.1016/S0140-6736(84)92625-4

DO - 10.1016/S0140-6736(84)92625-4

M3 - Article

C2 - 6148472

SN - 0140-6736

VL - 2

SP - 716

EP - 719

JO - The Lancet

JF - The Lancet

IS - 8405

ER -