[Color Doppler echography in the diagnosis of deep venous thrombosis of the lower limbs].

Abstract

Deep venous thrombosis (DVT) is a common and severe disease which can produce a pulmonary embolism as an acute consequence and post-phlebitic syndrome as a late complication. Since DVT symptoms and clinical features are almost no sensitive and specific, its diagnosis is usually achieved by instrumental exams. Until few years ago phlebography was considered the "gold standard" diagnostic test, although its invasivity prevented it from becoming routinely used in symptomatic and non-symptomatic patients. The aim of our study was to emphasize the usefulness of echo color Doppler (ECD), a non-invasive method, as a first-choice exam to diagnose and manage the therapy of DVT symptomatic patients and to address an early diagnosis in high risk non-symptomatic patients. We studied 375 patients, aged from 13 months to 92 years. In most of the cases patients were seen because suffering from DVT symptoms, after surgery, or because suspected to have a pulmonary embolism. All the patients underwent a venous ECD of the lower limbs, whereas 16 of them had also a phlebography. ECD disclosed an acute DVT in 15% of the patients and a chronic DVT in 3% of them, whereas 17% of the cases were diagnosed as having other pathologies which can clinically mimic a DVT. ECD sensitivity and specificity is higher than that of other exams, both invasive and non invasive, as it allows a thorough assessment of both iliac and distal vessels, a better detection of non-occluding wall thrombi, and has been found to be very helpful in the evaluation of chronic DVT changes.