[Value and place of real-time ultrasonic diagnosis combined with continuous-wave Doppler in the diagnosis and follow-up of thromboembolic disease].

The authors compared the results of real time ultrasound imaging and continuous wave Doppler (Echography-Doppler with bilateral venography and ilio-cavography in the diagnosis and the follow-up of deep venous thrombosis (D.V.T.). Diagnosis of D.V.T. The value of echography-Doppler (ED) compared to venography is studied on 297 patients (590 legs) suspected of D.V.T. (221) or pulmonary emboli (76). The two methods give concording results in 95% (563/590). Discrepancies (27) are more often located in distal veins. If we refer to venography as the gold standard, sensitivity of ED is 98% (236/242) and specificity is 95% (327/344). Other diagnosis are possible: hematoma (9), extrinsic compression (15), Baker's cyst (4), muscular problems (3)... Topographic value Sensitivity in isolated calf vein thrombosis is 90% (54/60 are detected, 22 are bilateral). 4/6 false negatives are located in the presumable healthy legs. Sensitivity in proximal D.V.T. is excellent 100% (182 D.V.T. with 28 bilateral). The upper extremity of the thrombus is located exactly by ED whatever the topography (35 in the inferior vena cava, three of them beyond the renal veins), the degree of obstruction (partially occluded veins: 32), and even if it's extended or not (27). Follow-up of D.V.T. Assessment of the results in 80 patients under treatment is identical with the two methods, whatever the topography, the degree of obstruction and the evolution of thrombosis. E.D. predictive value in therapeutic efficiency is discussed according to the evolution data in 260 patients. Screening of D.V.T. ED is compared to venography (13) and/or Fibrinogen test (15), in 23 patients (46 legs) with high risk of thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)