Ultrasonography of deep vein thrombosis of the lower extremity
Author:
Mikael Häggström [notes 1]
Planning
In certain circumstances, it may also be indicated in suspected pulmonary embolism, see pulmonary embolism.
Evaluation
Start as high as possible in the inguinal region where you can clearly see the external iliac vein, and then follow the femoral vein and popliteal vein with the probe. Compress the vein at regular distances, such as totaling at least 7 locations. Look for:
- Hyperechoic content.
- Absence of compressibility. However, adequate compression is usually not possible by the area where the vein passes through the adductor hiatus.
A decrease in Doppler flow raises the suspicion, but has less sensitivity and specificity.
Lower leg
If a lower ultrasound of the lower leg is indicated in the algorithm above, also evaluate the posterior tibial veins (at least distally near the ankle), the fibular veins (either beneath the posterior tibial vein, better seen when going about half way up the lower leg) as well as the anterior tibial vein (at least proximally).
Coronal plane, seen from medial side of lower leg, showing thrombosis of the fibular veins, with hyperechoic content and only marginal blood flow.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ Docent Henry Eriksson, Med dr, överläkare Fariba Baghaei, Specialistläkare Valerie Bockisch, Professor emerita Margareta Hellgren, Docent Leif Lapidus, Överläkare Per-Åke Moström, Med dr, Överläkare Vladimir Radulovic, Överläkare Lennart Stigendal. Djup ventrombos, DVT. Internetmedicin. Updated 2017-06-11
