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Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram

In 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the leas... Full description

Journal Title: The Lancet (British edition) 1984, Vol.2 (8405), p.716-719
Main Author: Sandler, D A
Other Authors: Martin, J F , Duncan, J S , Blake, G M , Ward, P , Ramsay, L E , Lamont, A C , Ross, B , Sherriff, S , Walton, L
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/6148472
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title: Diagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram
format: Article
creator:
  • Sandler, D A
  • Martin, J F
  • Duncan, J S
  • Blake, G M
  • Ward, P
  • Ramsay, L E
  • Lamont, A C
  • Ross, B
  • Sherriff, S
  • Walton, L
subjects:
  • Adolescent
  • Adult
  • Aged
  • Evaluation Studies as Topic
  • Female
  • Femoral Vein
  • Fibrinogen
  • Humans
  • Iliac Vein
  • Leg - anatomy & histology
  • Male
  • Middle Aged
  • Phlebography
  • Physical Examination
  • Plethysmography, Impedance
  • Popliteal Vein
  • Technetium
  • Thigh - anatomy & histology
  • Thrombophlebitis - diagnosis
  • Ultrasonography
ispartof: The Lancet (British edition), 1984, Vol.2 (8405), p.716-719
description: In 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the least accurate method. Impedance plethysmography, venoscan, and ultrasound had accuracies of 65%, 80%, and 82%, respectively. The initial X-ray venogram report had an accuracy of 90% compared with the interpretation of two experienced radiologists. The venoscan was equivocal in 32% of patients, and in the remaining patients the accuracy was 97%. Objective methods of investigation are essential for diagnosing deep-vein thrombosis. Of those tested, the X-ray venogram was the only investigation suitable for definitive diagnosis. The venoscan may have a role as a screening procedure, to be followed by X-ray venography in patients with equivocal venoscan results.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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titleDiagnosis of deep-vein thrombosis: comparison of clinical evaluation, ultrasound, plethysmography, and venoscan with X-ray venogram
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creatorSandler, D A ; Martin, J F ; Duncan, J S ; Blake, G M ; Ward, P ; Ramsay, L E ; Lamont, A C ; Ross, B ; Sherriff, S ; Walton, L
creatorcontribSandler, D A ; Martin, J F ; Duncan, J S ; Blake, G M ; Ward, P ; Ramsay, L E ; Lamont, A C ; Ross, B ; Sherriff, S ; Walton, L
descriptionIn 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the least accurate method. Impedance plethysmography, venoscan, and ultrasound had accuracies of 65%, 80%, and 82%, respectively. The initial X-ray venogram report had an accuracy of 90% compared with the interpretation of two experienced radiologists. The venoscan was equivocal in 32% of patients, and in the remaining patients the accuracy was 97%. Objective methods of investigation are essential for diagnosing deep-vein thrombosis. Of those tested, the X-ray venogram was the only investigation suitable for definitive diagnosis. The venoscan may have a role as a screening procedure, to be followed by X-ray venography in patients with equivocal venoscan results.
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subjectAdolescent ; Adult ; Aged ; Evaluation Studies as Topic ; Female ; Femoral Vein ; Fibrinogen ; Humans ; Iliac Vein ; Leg - anatomy & histology ; Male ; Middle Aged ; Phlebography ; Physical Examination ; Plethysmography, Impedance ; Popliteal Vein ; Technetium ; Thigh - anatomy & histology ; Thrombophlebitis - diagnosis ; Ultrasonography
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abstractIn 50 patients with suspected deep-vein thrombosis the diagnostic accuracy of standardised clinical examination, doppler ultrasound, impedance plethysmography, and technetium-99m-labelled-fibrinogen scintigraphy (venoscan) was compared with that of X-ray venography. Physical examination was the least accurate method. Impedance plethysmography, venoscan, and ultrasound had accuracies of 65%, 80%, and 82%, respectively. The initial X-ray venogram report had an accuracy of 90% compared with the interpretation of two experienced radiologists. The venoscan was equivocal in 32% of patients, and in the remaining patients the accuracy was 97%. Objective methods of investigation are essential for diagnosing deep-vein thrombosis. Of those tested, the X-ray venogram was the only investigation suitable for definitive diagnosis. The venoscan may have a role as a screening procedure, to be followed by X-ray venography in patients with equivocal venoscan results.
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pmid6148472