Tan Melanie, van Rooden Cornelis J, Westerbeek Robin E, Huisman Menno V
Section of Vascular Medicine, Department of General Internal Medicine - Endocrinology, Leiden University Medical Centre (LUMC), 2300 RC Leiden, The Netherlands.
Br J Haematol. 2009 Aug;146(4):347-60. doi: 10.1111/j.1365-2141.2009.07732.x. Epub 2009 May 19.
Deep vein thrombosis (DVT) is a common disease that may lead to potentially fatal complications, such as pulmonary embolism. In the past decades several diagnostic tools and algorithms for DVT have been studied. Currently the combination of a clinical decision rule, D-dimer testing and compression ultrasonography has proved to be safe and effective for the diagnosis of DVT in the lower extremities. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) can be useful as additional or secondary imaging modalities. This review will discuss the elements currently used in making the clinical diagnosis of DVT. These elements include clinical decision rules and D-dimer testing, different imaging investigations and the appropriate use of these within diagnostic algorithms in patients with clinically suspected DVT. Although current knowledge of the options available to diagnose DVT of the lower extremities is well established, there are still unresolved issues, including the optimal diagnosis of recurrent DVT and distal DVT. Furthermore, the diagnosis of DVT of the upper extremities will be discussed, including the different imaging modalities and the limitations of these techniques.
深静脉血栓形成（DVT）是一种常见疾病，可能导致潜在的致命并发症，如肺栓塞。在过去几十年中，已经对几种DVT诊断工具和算法进行了研究。目前，临床决策规则、D-二聚体检测和加压超声检查相结合已被证明对诊断下肢DVT安全有效。计算机断层扫描（CT）和磁共振成像（MRI）可用作辅助或二级成像方式。本综述将讨论目前用于DVT临床诊断的要素。这些要素包括临床决策规则和D-二聚体检测、不同的影像学检查以及在临床疑似DVT患者的诊断算法中对这些检查的合理应用。尽管目前对于诊断下肢DVT可用选项的认识已经很成熟，但仍存在一些未解决的问题，包括复发性DVT和远端DVT的最佳诊断。此外，还将讨论上肢DVT的诊断，包括不同的成像方式及其技术局限性。
