Department of Medicine-Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Semin Thromb Hemost. 2024 Jul;50(5):739-750. doi: 10.1055/s-0044-1779484. Epub 2024 Feb 19.
An accurate and prompt diagnosis of deep vein thrombosis and/or pulmonary embolism is important to prevent serious complications and mortality. Because the clinical presentation of venous thromboembolism (VTE) is often nonspecific, objective testing by means of radiological imaging is required to confirm the diagnosis. Historically, a diagnosis of VTE involved invasive imaging techniques like contrast venography or conventional pulmonary angiography. Technological developments toward more accurate and less invasive diagnostics have driven the implementation of a variety of newer technologies over the past decades, as well as the derivation and validation of clinical decision rules (CDRs) that can be used to rule out VTE in combination with D-dimer blood tests. In this narrative review, we provide a historical overview of the most notable developments in the imaging techniques and CDRs for VTE diagnosis.
准确、及时地诊断深静脉血栓形成和/或肺栓塞对于预防严重并发症和死亡至关重要。由于静脉血栓栓塞症(VTE)的临床表现通常不具有特异性,因此需要通过影像学手段进行客观检查以明确诊断。在过去,VTE 的诊断需要采用有创性影像学技术,如对比静脉造影或传统肺动脉造影。随着技术的发展,人们对更准确、更微创诊断的需求不断推动,过去几十年中出现了各种新技术,并开发和验证了临床决策规则(CDR),可结合 D-二聚体血液检测来排除 VTE。在本综述中,我们回顾了 VTE 诊断影像学技术和 CDR 的重要进展。