A Prospective Comparison of Four Methods for the Diagnosis of Deep Vein Thrombosis

Summary

A simultaneous prospective study was undertaken to compare the accuracy, usefulness and limitations of four methods (¹²⁵I-fibrinogen test, Doppler ultrasound technique, impedance phlebography and venography) for the diagnosis of acute and recurrent thrombophlebitis. We found that impedance phlebography was unreliable with an accuracy of 50% for the diagnosis of acute thrombophlebitis. The other three methods were reliable and had good correlation. Discrepancies among these methods were noted in recurrent thrombophlebitis. To determine whether the recurrence of symptomatology in these patients was due to an active process, the ¹²⁵I-fibrinogen test was extremely useful since it detected acute thrombotic activity. As expected, both the Doppler technique and venography were insensitive for this purpose. We conclude that in evaluating patients with recurrent thrombophlebitis, it is important to perform an ¹²⁵I-fibrinogen test which helps to avoid unnecessary anticoagulation.

• References

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