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March 29, 2004Circulation216 citationsOpen Access

Ultrasonography and Diagnosis of Venous Thromboembolism

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BZBrenda K. Zierler

Key Points

  • Review the clinical utility and effectiveness of venous ultrasonography as a primary diagnostic tool for acute lower extremity deep vein thrombosis and suspected pulmonary embolism.
  • Synthesized literature on venous ultrasonography performance as a standalone diagnostic examination for acute lower extremity deep vein thrombosis.
  • Evaluated multimodality diagnostic strategies integrating ultrasonography with clinical probability assessments and D-dimer testing, as well as algorithms for suspected pulmonary embolism.
  • Highlights venous ultrasonography as the diagnostic foundation for acute deep vein thrombosis due to the poor sensitivity and specificity of physical examination alone.
  • Assesses the clinical trade-offs between standalone ultrasound protocols and integrated testing algorithms incorporating pretest probability scores and D-dimer assays.

Abstract

Venous thromboembolism (VTE) consists of two related conditions: pulmonary embolism (PE) and deep vein thrombosis (DVT). Objective testing for VTE is crucial because the clinical diagnosis is nonspecific and insensitive, and the consequences of a missed diagnosis are serious. The purpose of this review is to discuss the utility of venous ultrasonography as the foundation for diagnosis of acute lower extremity DVT. The effectiveness and practicality of venous ultrasonography as a stand-alone examination versus theoretically attractive, but perhaps less practical, combined approaches of ultrasonography with clinical probability assessment and D-dimer testing in the diagnosis of acute DVT is also addressed. Finally, the role of venous ultrasonography in a diagnostic algorithm for suspected PE is discussed.

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Cite This Study

Brenda K. Zierler (2004) studied this question.

synapsesocial.com/papers/6a0e1924d4969e46f6d08832https://doi.org/10.1161/01.cir.0000122870.22669.4a
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Diagnostic Considerations of Venous Thromboembolic Disease2017 · 3 citations
  2. 2Duplex ultrasound for diagnosis of deep vein thrombosis2007 · 3 citations
  3. 3The Diagnosis of Venous Thromboembolism2012 · 21 citations
  4. 4Diagnosis of deep vein thrombosis1997 · 16 citations
  5. 5Review of the Evidence on Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism2007 · 143 citations