The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Low Accuracy of Color Doppler Ultrasound in the Detection of Proximal Leg Vein Thrombosis in Asymptomatic High-Risk Patients

Bruce L. Davidson, MD, MPH; C. Gregory Elliott, MD; Anthonie W. A. Lensing, MD, PhD, RD Heparin Arthroplasty Group*>
[+] Article, Author, and Disclosure Information

Grant Support: In part by Wyeth-Ayerst Research.

Requests for Reprints: Bruce L. Davidson, MD, MPH, Wyeth-Ayerst Research, P. O. Box 8299, Philadelphia, PA 19101.

Current Author Addresses: Dr. Davidson: Wyeth-Ayerst Research, P. O. Box 8299, Philadelphia, PA 19101.

Dr. Elliott: Pulmonary Division, LDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143.

Dr. Lensing: Academic Medical Center, Meibergdreef 9, Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, 1105 A2 Amsterdam, The Netherlands.

© 1992 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1992;117(9):735-738. doi:10.7326/0003-4819-117-9-735
Text Size: A A A

Objective: To evaluate the ability of color Doppler ultrasound to detect proximal deep venous thrombosis (DVT) in asymptomatic high-risk patients who subsequently underwent contrast venography.

Design: Prospective cohort study using blinded observers, with contrast venography as the comparison standard.

Setting: Seven medical centers (university and community hospitals) participating in a clinical trial of low-molecular-weight heparin for prevention of DVT.

Patients: A total of 385 consecutive patients undergoing elective unilateral hip or knee replacement.

Measurements: Ten days after surgery or before hospital discharge (whichever occurred first), patients had bilateral color Doppler ultrasound examinations of the proximal veins of the lower extremities. Subsequently, a contrast venogram of the operated leg was obtained.

Results: Color Doppler ultrasound studies and venograms were both evaluable in 319 of the 385 patients. Deep venous thrombosis was identified by contrast venography in 80 patients (prevalence, 25%; 95% Cl, 20% to 30%) and involved the proximal veins in 21 patients (prevalence, 7%; Cl, 4% to 10%). For proximal DVT, color Doppler ultrasound showed poor sensitivity (38%; Cl, 18% to 62%), moderately good specificity (92%; Cl, 89% to 95%), and a poor positive predictive value for this population (26%).

Conclusion: Color Doppler ultrasound examinations are insensitive to proximal DVT in asymptomatic high-risk patients and should not be substituted for venography for identifying proximal DVT in such patients.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.