The Use of Doppler Ultrasound to Diagnose Deep Vein Thrombosis of the Lower Limbs

Authors

  • Nagla Hussein Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, Najran University, KSA
  • Mohamed Khalid Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, Najran University, KSA,

DOI:

https://doi.org/10.14738/jbemi.94.9302

Abstract

In most cases of pulmonary embolism, death occurs as a result of deep vein thrombosis (DVT) of the lower extremities. Therefore, to avoid DVT complications and sequel, DVT must be diagnosed as early as possible and this can be achieved via B-mode and colour Doppler imaging. The present paper seeks to investigate the suitability of the imaging method of ultrasound for lower extremity DVT diagnosis and to explore the outcomes of the use of this method in DVT cases. To this end, the paper undertakes a retrospective descriptive study of 50 cases of ultrasound-based diagnosis of DVT at King Khalid Hospital in the period between January 2019 and August 2020. Half of the cases were subjected to compression, colour, and duplex ultrasound, 14 cases were subjected to compression and duplex ultrasound, and 11 cases were subjected to compression and colour Doppler. The mean age across all cases was 46.2±19.9 years. The majority of cases (56%) were in the age range 22-41 years old (n=28), while 28% of cases were in the age range 42-61 years old (n=14), 6% of cases were in the age range 62-81 years old (n=3), and 10% of cases were in the age range 82-102 years old (n=5). Regarding sex, females accounted for 60% of cases, while males accounted for the rest of 40%. Furthermore, in 90% of cases (n=45), just one lower extremity was affected, whereas in 10% of cases (n=5), both lower extremities were affected. Regarding thrombus location, it was found mostly in the area above the knee, particularly the popliteal vein (34%), common femoral vein (18%), and superficial femoral vein (20%). Moreover, 2% of cases presented thrombus in the calf vein. In 26% of cases, multiple veins were affected. DVT was acute in 76% of cases (n=38) and chronic in 24% of cases (n=12). It is concluded that symptomatic and at-risk cases benefit from the use of ultrasound for DVT diagnosis. The suitability of this method stems from its lack of invasiveness and capability to assess thrombus location, magnitude, and stage.

References

(1) Piazza G, Goldhaber SZ. Acute pulmonary embolism: part I: epidemiology and diagnosis. Circulation. 2006;114(2):e28–32. [PubMed] [Reference list

(2) Andra H. James, Thomas L. Ortel, Victor F. Tapson: 100 Questions & Answers About Deep Vein Thrombosis and Pulmonary Embolism: Copyright © 2008 by Jones and Bartlett Publishers, Inc. ISBN-13: 978-0-7637-4105-1 PAGE 1-6

(3) Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ (June 2019). "Deep vein thrombosis: update on diagnosis and management". The Medical Journal of Australia. 210 (11): 516–524. doi:10.5694/mja2.50201. PMID 31155730.

(4) Blann AD , Lip GYH, Venous thromboembolism. BMJ 2006;332:215–219.

(5) Prandoni P , Lensing AWA , Cogo A ,Enrico Baernardi,Anthoniew W . The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 1996;125:1–7.

(6) Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Heit JA.Prevention of venous thromboembolism: American Collegeof Chest Physicians Evidence- Based Clinical Practice Guidelines (8thedition). 2008 Chest 133 (6 Suppl.):381S–453S

(7) Heit JA, Cohen AT, Anderson FA Jr., on behalf of the VTE Impact Assessment Group. Estimated annual number of incident and recurrent, non-fatal and fatal venous thromboembolism (VTE) events in the US. ASH Ann Meeting Abstr 2005; 106:910.

(8) Thrombosis Anthony J. Comerota Lowell S. Kabnick, Neil S. SadickPUBLISHED: Deep Vein Thrombosis: 2014 by Taylor & Francis Group, LLCCRC : 978-1-4441-4610-3

(9) Intersocietal Accreditation Commission. ICAVL: Essentials and standards for accreditation in noninvasive vascular testing. Part II. Vascular laboratory operations – Peripheral venous testing. 2000: 1–8. Available at: www.intersocietal.org/intersocietal.htm. Accessed December 15, 2003

(10) Kearon C , Julian JA , Math M , Brenda K. Zierler.,Noninvasive diagnosis of deep vein thrombosis. McMaster Diagnostic Imaging Practice Guidelines Initiative. Ann Intern Med. 1998; 128: 663–677. CrossRefMedline

(11) . Killewich LA, Bedford GR, Beach ICW, Strandness DE Jr. Diagnosis of deep venous thrombosis: a prospective study comparing duplex scanning to contrast venography. Circulation1989;79:810-4.

(12) Comerota AJ, Katz ML, Greenwald LL, Leefmans E, Czeredarczuk M, White IV. Venous duplex imaging: should it replace hemodynamic tests for deep venous thrombosis? J Vase Surg 1990; 11:53-61.

(13) Hill SL, Holtzman GI, Martin D, Evans P, Toler W, Goad K. The origin of lower extremity deep vein thrombi in acute venous thrombosis. Am J Surg 1997; 173:485-90.

(14) Hill SL, Holtzman GI, Martin D, Evans P, Toler W, Goad K. Selective use of the duplex scan in diagnosis of deep venous thrombosis. Am J Surg 1995; 170:201-5.

(15) Sheiman RG, McArdle CR. Bilateral lower extremity US in the patient with unilateral symptoms of deep venous thrombosis: Assessment of need. Radiology 1995; 194:171-3.

(16) Markel A, Manzo RA, Bergelin RO, Strandness DE Jr. Pattern and distribution of thrombi in acute venous thrombosis. Arch Surg 1992; 127:305-9.

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Published

2021-10-21

How to Cite

Hussein, N. ., & Khalid, M. . (2021). The Use of Doppler Ultrasound to Diagnose Deep Vein Thrombosis of the Lower Limbs. Journal of Biomedical Engineering and Medical Imaging, 8(4), 7–13. https://doi.org/10.14738/jbemi.94.9302