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Ultrasound elastography is useful to distinguish acute and chronic deep vein thrombosis.
Mumoli, N; Mastroiacovo, D; Giorgi-Pierfranceschi, M; Pesavento, R; Mochi, M; Cei, M; Pomero, F; Mazzone, A; Vitale, J; Ageno, W; Dentali, F.
Afiliación
  • Mumoli N; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Mastroiacovo D; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Giorgi-Pierfranceschi M; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Pesavento R; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Mochi M; General Electric Healthcare, Milano, Italy.
  • Cei M; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Pomero F; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Mazzone A; Department of Internal Medicine, Livorno Hospital, Livorno, Italy.
  • Vitale J; Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy.
  • Ageno W; Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy.
  • Dentali F; Department of Clinical and Experimental Medicine, Insubria University, Varese, Italy.
J Thromb Haemost ; 16(12): 2482-2491, 2018 12.
Article en En | MEDLINE | ID: mdl-30225971
Essentials Ultrasound elastography uses tissue deformation to assess the relative quantification of its elasticity. Compression and duplex ultrasonography may be unable to correctly determine the thrombus age. Ultrasound elastography may be useful to distinguish between acute and chronic deep vein thrombosis. The exact determination of the thrombus age could have both therapeutic and prognostic implications. BACKGROUND: Background Ultrasound elastography (UE) imaging is a novel sonographic technique that is commonly employed for relative quantification of tissue elasticity. Its applicability to venous thromboembolic events has not yet been fully established; in particular, it is unclear whether this technique may be useful in determining the age of deep vein thrombosis (DVT). Thus, the aim of this study was to assess the role of UE in distinguishing acute from chronic DVT. Methods Consecutive patients with a first unprovoked acute and chronic (3 months old) DVT of the lower limbs were analyzed. Patients with recurrent DVT or with a suspected recurrence were excluded. The mean elasticity index (EI) values of acute and chronic popliteal and femoral vein thrombosis were compared. The accuracy of the EI in distinguishing acute from chronic DVT was also assessed by measuring the sensitivity, specificity, positive and negative predictive values, and likelihood ratios. Results One-hundred and forty-nine patients (mean age 63.9 years, standard deviation 13.6; 73 males) with acute and chronic DVT were included. The mean EI of acute femoral DVT was higher than that of chronic femoral DVT (5.09 versus 2.46), and the mean EI of acute popliteal DVT was higher than that of chronic popliteal DVT (4.96 versus 2.48). An EI value of > 4 resulted in a sensitivity of 98.9% (95% confidence interval [CI] 93.3-99.9), a specificity of 99.1% (95% CI 94.8-99.9), a positive predictive value of 91.1% (95% CI 77.9-97.1), a negative predictive value of 98.6% (95% CI 91.3-99.9), a positive likelihood ratio of 13.23 (95% CI 93-653) and a negative likelihood ratio of 0.001 (95% CI 0.008-0.05) for acute DVT. Conclusions UE appears to be a promising technique for distinguishing between acute and chronic DVT. Larger prospective studies are warranted to confirm our preliminary findings.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trombosis de la Vena / Diagnóstico por Imagen de Elasticidad Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Trombosis de la Vena / Diagnóstico por Imagen de Elasticidad Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Thromb Haemost Asunto de la revista: HEMATOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Italia