Thromb Haemost 1989; 61(03): 363-365
DOI: 10.1055/s-0038-1646596
Original Article
Schattauer GmbH Stuttgart

Comparison of Real-Time B-Mode Ultrasonog raphy and Bilateral Ascending Phlebography for Detection of Postoperative Deep Vein Thrombosis Following Elective Hip Surgery

Lars C Borris
The Venous Thrombosis Group, Depts. of Orthopedics and Radiology, Aalborg Hospital, Aalborg, Denmark
,
Hanne M Christiansen
The Venous Thrombosis Group, Depts. of Orthopedics and Radiology, Aalborg Hospital, Aalborg, Denmark
,
Michael R Lassen
The Venous Thrombosis Group, Depts. of Orthopedics and Radiology, Aalborg Hospital, Aalborg, Denmark
,
Agnete D Olsen
The Venous Thrombosis Group, Depts. of Orthopedics and Radiology, Aalborg Hospital, Aalborg, Denmark
,
Peder Schøtt
The Venous Thrombosis Group, Depts. of Orthopedics and Radiology, Aalborg Hospital, Aalborg, Denmark
,
(The Venous Thrombosis Group) › Author Affiliations
Further Information

Publication History

Received 30 September 1988

Accepted after revision 20 January 1989

Publication Date:
24 July 2018 (online)

Summary

A prospective study compared real-time B-mode ultrasound examination with bilateral ascending phlebography in the diagnosis of postoperative deep vein thrombosis in 60 patients undergoing elective total hip replacement. The overall sensitivity and specificity of the ultrasound method were 54 and 91%, respectively, and the positive and negative predictive values were 83 and 69%, respectively. The rather low overall sensitivity of the ultrasound method in this study was due to difficulty in detecting thrombi smaller than 1 cm wherever they were located in the deep veins, and in diagnosing thrombi in the calf, regardless of their size. We conclude that real-time B-mode ultrasonography is a technique that can easily be used routinely for detection of postoperative DVT in hip surgery, but its sensitivity for proximal thrombosis (63%) is too low for it to be used alone.

 
  • References

  • 1 Dauzat MM, Laroche J-P, Charras C, Blin B, Domingo-Faye M-M, Sainte-Luce P, Domergue A, Lopez F-M, Janbon C. Real-time B-mode ultrasonography for better specificity in the noninvasive diagnosis of deep vein thrombosis. J ultrasound Med 1986; 5: 625-631
  • 2 Appelman PT, De Jong TE, Lampmann LE. Deep venous thrombosis of the leg: US findings. Radiology 1987; 163: 743-746
  • 3 Raghavendra BN, Rosen RJ, Lam S, Riles T, Horii SC. Deep venous thrombosis: Detection by high-resolution real-time ultrasonography. Radiology 1984; 152: 789-793
  • 4 Aitken AG F, Godden DJ. Real-time ultrasound diagnosis of deep vein thrombosis: A comparison with venography. Clin Radiol 1987; 38: 309-313
  • 5 Sullivan ED, Peter DJ, Cranley JJ. Real-time B-mode venous ultrasound. J Vase Surg 1984; 1: 465-471
  • 6 Christensen SW, Wille-Jørgensen P, Kjaer L, Stadeager C, Widding A, Vestergaard A, Bjerg-Nielsen A. Contact thermography,99mTc-plasmin scintimetry and99mTc-plasmin scintigraphy as screening methods for deep venous thrombosis following major hip surgery. Thromb Haemostas 1987; 58: 831-833
  • 7 Harris WH, Athanasoulis C, Waltman AC, Salzman EW. Cuff-impedance phlebography and 125-I-fibrinogen scanning versus roent-genographic phlebography for diagnosis of thrombophlebitis following hip surgery. J Bone Joint Surg 1976; 58 A 939-944
  • 8 Raghavendra BN, Horii SC, Hilton S, Subramanyam BR, Rosen RJ, Lam S. Deep venous thrombosis: Detection by probe compression of veins. J Ultrasound Med 1986; 5: 89-95
  • 9 Rabinov K, Paulin S. Roentgendiagnosis of venous thrombosis in the leg. Arch Surg 1972; 104: 134-144
  • 10 Zachrisson BE, Jansen H. Phlebographic signs in fresh postoperative venous thrombosis of the lower extremity. Acta Radiol (Diagn) 1973; 14: 82-96
  • 11 Griner PF, Mayewski RJ, Mushlin AI, Greenland P. Selection and interpretation of diagnostic tests and procedures. Principles and applications Ann Intern Med 1981; 94: 559-563
  • 12 Lassen MR, Borris LC, Christiansen HM, Møller-Larsen F, Knudsen VE, Boris P, Nehen A-M, de Carvalho A, Jurik A-G, Nielsen BW, Lucht U. Heparin/dihydroergotamine for venous thrombosis prophylaxis: comparison of low-dose heparin and low molecular weight heparin in hip surgery. Br J Surg 1988; 75: 686-689
  • 13 Olsson C-G. A modified 125-I-fibrinogen technique for thrombus detection in the whole leg. Scand J Clin Lab Invest 1979; 39: 677-684
  • 14 Lindblad B, Bergqvist D, Fredin H, Jaroszewski H, Nosslin B. The accuracy of 125-I-radioactive uptake test for detection of deep venous thrombosis using different labelled proteins (fibrinogen, albumin) and compared to phlebography in hip surgery patients. Vasa 1987; 16: 251-255
  • 15 Bergqvist D. Postoperative thromboembolism. Springer-Verlag; Berlin: 1983. p 8
  • 16 Coelho JC U, Sigel B, Ryva JC, Machi J, Renigers SA. B-mode sonography of blood clots. J Clin Ultrasound 1982; 10: 323-327