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Sensitivity and Specificity of Ultrasonography in the Diagnosis of Upper Extremity Deep Vein Thrombosis
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mustafa, Bisher O. Rathbun, Suman W. Whitsett, Thomas L. Raskob, Gary E. |
| Copyright Year | 2017 |
| Abstract | U PPER EXTREMITY deep vein thrombosis is an increasingly common clinical problem. It may cause pulmonary embolisms, including fatal embolisms. Therefore, accurate diagnosis is essential. The clinical diagnosis of upper extremity deep vein thrombosis is nonspecific. Its prevalence is less than 50% among symptomatic patients, necessitating objective testing to confirm or exclude the diagnosis. While venography remains the diagnostic reference standard, it is invasive, has an associated risk of thrombophlebitis, and may be unavailable or impractical. Ultrasonography is the most frequently used objective test. However, in contrast to patients with suspected deep vein thrombosis of the legs, the validity of ultrasonographic testing for suspected upper extremity deep vein thrombosis is uncertain. Anatomical differences between the upper and lower extremity deep venous system may influence the performance characteristics of ultrasonography for the diagnosis of upper extremity deep vein thrombosis. For example, the ability to image and compress the middle of the subclavian vein is hindered by the overlying segment of the clavicle. Moreover, which vessels are imaged and the diagnostic criteria for the presence or absence of deep vein thrombosis vary. Most commonly, the subclavian and axillary veins are imaged, but ultrasonographic testing for upper extremity deep vein thrombosis may also include imaging of the internal jugular, innominate, brachial, and basilic veins. Real-time ultrasonography is used to assess the presence or absence of vein compressibility and the echogenicity within the vein lumen. Doppler ultrasonography evaluates the characteristics of venous flow, including phasicity, pulsatility, and variation with physiologic maneuvers. Duplex ultrasonography uses combined real-time imaging and Doppler ultrasonographic assessment. Color flow Doppler imaging enables the assessment of the presence and direction of venous flow. REVIEW ARTICLE |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://archinte.jamanetwork.com/journals/InteMed/articlepdf/211222/ira10032.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
