Sonographical investigations in the diagnosis of deep venous thrombosis

Acute deep venous thrombosis of the leg is an often observed and a potentially lethal disease due to the complication of pulmonary embolism. It presents with a wide range of symptoms varying between distinct signs of venous obstruction and very mild congestion. Since the validity of the clinical examination is unreliable, imaging should always be carried out in case of suspected thrombosis. This paper describes the use of continuous wave Doppler sonography, B-mode sonography, duplex sonography and colour-coded Doppler sonography when diagnosing a thrombosis. It also compares the validity of these methods at several topographical locations with phlebography. Overall, for experienced examiners B-mode compression sonography and colour-coded duplex sonography can be recommended as a key investigation in diagnostics of deep vein thromboses. Only findings of dubious value in the iliac, femoral or calf veins require a venography to confirm or exclude a clinical suspicion of deep vein thrombosis.