UMEM Educational Pearls

Category: Vascular

Title: CT Venography and Leg Ultrasound for DVT Evaluation

Keywords: CT Venogram, Ultrasound, DVT, Deep Venous Thrombosis( (PubMed Search)

Posted: 6/2/2008 by Rob Rogers, MD (Updated: 10/18/2019)
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What study should we be getting to evaluate for DVT in patients with suspected VTE (venous thromboembolic disease)?

Ultrasound of the legs seems to be equivalent to CT Venography (CTV). 

Drawbacks of CT Venography (CT scanning into the abdomen/pelvis/legs after pulmonary CTPA):

  • Radiation (TONS of radiation!)
  • Cost
  • Never been proven superior to non-invasive ultrasound

Despite the fact that leg ultrasound obviously doesn't evaluate for deep pelvis clots and intraabdominal clots (IVC, etc), outcome studies and other studies in recent years show ultrasound is just as good as  CTV. 

 

References

 Goodman LR, et al. CT Venography and Compression Sonography are Diagnostically Equivalent: Data from PIOPED II. Am J Roent 2007