Abstract
Objective
To compare the accuracy of indirect mutidetector row computed tomographic (MDCT) venography
with lower extremity venous sonography for the diagnosis of femoropopliteal deep venous
thrombosis (DVT), and to determine the frequency and location of DVT at MDCT venography.
Materials and methods
Twenty-six consecutive patients suspected of having pulmonary embolism (PE) underwent
both combined MDCT venography and MDCT pulmonary angiography and lower extremity venous
sonography. Indirect MDCT venography was acquired from the upper calves to the mid-abdomen
following MDCT pulmonary angiography. The CT venographic findings were compared with
those of sonography for the diagnosis of femoropopliteal DVT. All CT scans were also
reviewed for the frequency and location of DVT.
Results
Indirect MDCT venography disclosed DVT in 19 patients, and 12 of whom also had PE.
Seventeen patients with thrombosis in the femoropopliteal veins were identified in
both indirect MDCT venography and sonography. The sensitivity and specificity of indirect
MDCT venography for femoropopliteal DVT, as compared with sonography, were both 100%.
In one patient DVT in the superficial femoral vein was detected using only indirect
MDCT venography. MDCT venography also showed superior extension of femoropopliteal
DVT to the inferior vena cava and iliac veins in four patients and thrombosis isolated
to the inferior vena cava and common iliac vein thrombosis in one patient.
Conclusions
Indirect MDCT venography is as accurate as sonography in the diagnosis of femoropopliteal
DVT. MDCT venography can further reveal thrombus in large pelvis veins and the inferior
vena cava, an important advantage over sonographic screening for DVT.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Management of deep vein thrombosis and pulmonary embolism.Circulation. 1996; 93: 2212-2245
- Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study.Arch Intern Med. 1998; 158: 585-593
- Pulmonary embolism.N Engl J Med. 1999; 339: 93-104
- The origin of thrombi in the deep veins of the lower limb: a venographic study.Br J Surg. 1978; 65: 449-451
- Residual venous thrombosis as a predictive of recurrent venous thromboembolism.Ann Intern Med. 2002; 137: 955-960
- Combined CT venography and pulmonary angiography: a new diagnostic technique for suspected thromboembolic disease.AJR Am J Roentgenol. 1998; 170: 951-954
- Combined CT venography and pulmonary angiography in suspected thromboembolic disease: diagnostic accuracy for deep venous evaluation.AJR Am J Roentgenol. 2000; 174: 61-65
- Thromboembolic disease: comparison of combined CT pulmonary angiography and venography with bilateral leg sonography in 70 patients.AJR Am J Roentgenol. 2000; 175: 997-1001
- Deep venous thrombosis with suspected pulmonary embolism: detection with combined CT venography and pulmonary angiography.Radiology. 2001; 219: 498-502
- Deep venous thrombosis: detection by using indirect CT venography.Radiology. 2000; 216: 744-751
- Evaluation of the deep venous system in patients with suspected pulmonary embolism with multidetector CT: a prospective study in comparison to Doppler zoography.J Comput Assist Tomogr. 2003; 27: 399-409
- Optimization of combined CT pulmonary angiography with lower extremity CT venography.AJR Am J Roentgenol. 2000; 174: 67-69
- Combined CT venography and pulmonary angiography: how much venous enhancement is routinely obtained?.AJR Am J Roentgenol. 2001; 176: 1281-1285
- Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media.Radiology. 1987; 165: 113-116
- Cost effectiveness of clinical diagnosis, venography, and noninvasive testing in patients with symptomatic deep vein thrombosis.N Engl J Med. 1981; 304: 1561-1567
- Lower-limb deep venous thrombosis: direct MR imaging of the thrombus.Radiology. 1998; 209: 349-355
- Deep venous thrombosis of the lower extremity: efficacy of spiral CT venography compared with conventional venography in diagnosis.Radiology. 1996; 200: 423-428
- Spiral CT venography of the lower extremity.AJR Am J Roentgenol. 1994; 163: 451-453
- Evaluation of the lower extremity veins in patients with suspected pulmonary embolism: a retrospective comparison of helical CT venography and sonography.AJR Am J Roentgenol. 2000; 175: 1525-1531
- Spiral CT venography of the lower extremity by injection of an arm vein in patients with leg swelling.Br J Radiol. 2001; 74: 1013-1016
- Pulmonary embolism revealed on helical CT angiography: comparison with ventilation-perfusion radionuclide lung scanning.AJR Am J Roentgenol. 2000; 174: 1041-1047
- CT evaluation of pulmonary embolism: technique and interpretation.AJR Am J Roentgenol. 1997; 169: 959-965
- Combined CT venography and pulmonary angiography: a comprehensive review.Radiographic. 2002; 22: S3-S24
- High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism.Chest. 1999; 116: 903-908
- Iliocaval thrombi in pulmonary thromboembolic disease.AJR Am J Roentgenol. 1976; 126: 1019-1022
- Color Doppler imaging versus phlebography in the diagnosis of deep leg and pelvic vein thrombosis.J Ultrasound Med. 1997; 16: 31-37
- Subsegmental pulmonary emboli: improved detection with thin-collimation multidetector row spiral CT.Radiology. 2002; 222: 483-490
- Detection of deep venous thrombosis: prospective comparison of MR imaging and contrast venography.AJR Am J Roentgenol. 1993; 161: 131-139
- Assessment of deep venous thrombosis in the lower limbs and pelvis: MR venography versus duplex Doppler sonography.AJR Am J Roentgenol. 1996; 167: 971-975
- Indirect CT venography following pulmonary angiography.J Thorac Imaging. 2002; 17: 18-27
- Deep venous thrombosis: recent advances and optimal evaluation with US.Radiology. 1999; 211: 9-24
- Sonography and venography of the lower extremity for diagnosing deep vein thrombosis in symptomatic patients.Clin Imaging. 2003; 27: 180-183
Article info
Publication history
Published online: October 01, 2004
Received:
November 7,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
