[Compression sonography as a procedure in the diagnosis of acute deep venous thrombosis of the leg].

It is well known that clinical symptoms of deep venous thrombosis of the leg are not reliable. We studied the diagnostic value of compression sonography in the diagnosis of venous thrombosis of the lower extremity. Ultrasound examination was performed in patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh lacking compressibility of the venous lumen was the only criterion for thrombosis. In the calf, unobstructed veins can usually not be seen in the patient supine. In thrombosis however the vessel is dilated by the clot and appears as sonolucent incompressible channel. 178 patients were examined comparatively by venography and ultrasound (226 one extremity phlebogramms). Phlebography demonstrated 113 thromboses which could be demonstrated by ultrasound with a sensitivity of 95% and a specificity of 100%. In 92% the extension of thrombosis was estimated accurately. Thigh vein thrombosis was detected with a sensitivity of 97% and a specificity of 99%. Occlusion or patency of the common femoral vein was seen correctly in each case. Ultrasonic diagnosis of the superficial femoral vein thrombosis had a sensitivity of 97%, that of the popliteal vein of 98% and a specificity of 100% in both. Venous occlusion confined to the calf was detected with a sensitivity of 89% and a specificity of 99%. We conclude that compression sonography is a highly accurate diagnostic procedure for the diagnosis of deep venous thrombosis of the thigh as well as the calf. It should be the first choice of imaging method in the diagnosis of venous thrombosis of the leg.