CUS for DVT

Q: Compression ultrasonography (CUS) is more sensitive and specific in Deep Venous Thrombosis (DVT) for? (select one)

A) proximal veins

B) distal veins

Answer: A

Compression ultrasonography (CUS) with Doppler is the diagnostic test of choice in patients with suspected DVT. The non-compressibility of the imaged vein determines the test's positivity.

The proximal veins, i.e., the common femoral, deep femoral, and popliteal veins, are easy to access and more visible for compressibility. Their sensitivity and specificity are almost >95 percent for the test. The distal veins, i.e., the peroneal, posterior and anterior tibial, and muscular veins, do not have such great sensitivity and specificity. 

Calf and iliac vein thrombosis are difficult to determine as calf veins are less readily compressed, and iliac veins often cannot be assessed.

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#procedures

References: 

1. Needleman L, Cronan JJ, Lilly MP, et al. Ultrasound for Lower Extremity Deep Venous Thrombosis: Multidisciplinary Recommendations From the Society of Radiologists in Ultrasound Consensus Conference. Circulation 2018; 137:1505.

2. Lensing AW, Doris CI, McGrath FP, et al. A comparison of compression ultrasound with color Doppler ultrasound for the diagnosis of symptomless postoperative deep vein thrombosis. Arch Intern Med 1997; 157:765.

3. Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ. Deep vein thrombosis: update on diagnosis and management. Med J Aust. 2019 Jun;210(11):516-524. doi: 10.5694/mja2.50201. Epub 2019 Jun 2. PMID: 31155730.