Utilidad de la ecografía abdominal en el estudio etiológico de la enfermedad tromboembólica venosa idiopática como método diagnóstico de la neoplasia oculta

Purpose

To determine the sensibility of abdominal ultrasound (US) in the screening of occult cancer in patients with idiopathic venous thromboembolism (iVTE).

To evaluate its sensitivity and specificity in different subgroups of patients with iVTE, in order to detect potential beneficiaries in whom the abdominal US screening may have greater diagnostic benefit.

Descriptive analysis of the use of abdominal US in these patients, and evaluation of its impact on their management.

Material and methods

We retrospectively searched all patients with confirmed iVTE (by Doppler-US, by CT angiography or V/Q scintigraphy) between 2011-2014, which had been performed an abdominal US for screening of occult malignancy as part as their aetiology study of VTE. As reference we set a follow-up period of 2 years.

Results

280 patients were found, and 209 were included after inclusion and exclusion criteria were applied. Abdominal US was positive for malignancy in 7 patients (3.3%). The sensitivity and specificity for cancer detection were 43.75% and 99.48%, respectively. Cancer was found in 16 patients in the 2-year follow-up (7.6%). No significant differences were found in the different subgroups of patients. Nevertheless, 28 patients (13.4%) were diagnosed of other cause of VTE during aetiology study, mainly hypercoagulability disorders.

Conclusions

Abdominal US for screening of occult malignancy in patients with iVTE is a very specific test but has low sensitivity, which compromises its utility as a routine screening test in these patients. Its use could be optimised by performing it only in selected subgroups of patients that need to be established in future research.