Is Color-Flow Duplex a Good Diagnostic Test for Detection of Isolated Calf Vein Thrombosis in High-Risk Patients?

• Published in: Angiology Vol. 51; no. 9; pp. 705 - 710
• Main Authors: Sugimoto, Hiroatsu, Richardson, Tracey, Webster, Marshall W., Makaroun, Michel S., Eskandari, Mark K.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Thousand Oaks, CA SAGE Publications 01-09-2000; Westminster; SAGE PUBLICATIONS, INC
• Subjects: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Biological and medical sciences; Cardiovascular system; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Phlebography; Postoperative Complications - diagnostic imaging; Predictive Value of Tests; Retrospective Studies; Risk Factors; Thrombophlebitis - diagnostic imaging; Ultrasonic investigative techniques; Ultrasonography, Doppler, Color; Sonography; Human; Lower limb; Cardiovascular disease; Duplex ultrasonography; Thrombosis; Color image; Venous disease; Leg; Vascular disease; Calf(anatomy); Medical imagery; Deep vein; Diagnosis
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/000331970005100901

Color-flow duplex scanning (CDS) is a good diagnostic test for lower extremity proximal deep vein thrombosis (DVT). This report aims to evaluate the diagnostic accuracy of CDS in detecting isolated calf DVT in two in-hospital populations. A total of 166 patients had routine DVT testing with both CDS and venography: 99 total joint arthroplasty patients and 67 symptomatic in-hospital patients. Isolated calf DVT was noted in 34% of arthroplasty patients and 12% of symptomatic in-hospital patients. Peroneal DVT was most common. The sensitivity, specificity, positive predictive value, and negative predic tive value (with 95% confidence interval [CI]) of CDS in detecting isolated calf DVT in the symptomatic in-hospital group was 39% (16%-62%), 98% (94%-99%), 88% (65%- 99%), and 81% (71%-91%), respectively. In the arthroplasty patients these values were 13% (3%-23%), 92% (85%-99%), 60% (30%-90%), and 55% (45%-65%), respec tively. CDS has a low sensitivity in detecting isolated calf DVT among hospitalized patients and cannot be deemed an effective tool for identifying clots limited to only one or two tibial vessels.