Sheiman R G, Weintraub J L, McArdle C R
Department of Radiology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215, USA.
Radiology. 1995 Aug;196(2):379-81. doi: 10.1148/radiology.196.2.7617848.
To assess the frequency of lower extremity deep venous thrombosis (DVT) detected with ultrasound (US) in patients with bilateral symptoms suggestive of DVT.
Fifty patients with bilateral lower extremity symptoms suggestive of DVT were examined prospectively for predisposing factors and type of symptoms. Charts were reviewed for previous lower extremity disease or chronic illness that could explain the patient's symptoms. The frequency of DVT diagnosed with US in this patient group was determined.
No DVT was identified in the patients with bilateral symptoms suggestive of DVT. Retrospective review demonstrated that 34 (68%) of the patients had a preexisting condition (cardiac disease, venous insufficiency, chronic swelling, cellulitis or thrombophlebitis, peripheral arterial disease). Because compression US has a greater than 90% sensitivity and specificity for the diagnosis of DVT, these results were statistically significant (P < .001).
The likelihood of DVT in patients with bilateral lower extremity symptoms is extremely low. Alternative causes should be carefully explored before lower extremity US is considered.
评估超声（US）检测双侧出现提示深静脉血栓形成（DVT）症状患者下肢深静脉血栓形成（DVT）的频率。
对50例双侧下肢出现提示DVT症状的患者进行前瞻性检查，以确定易感因素和症状类型。查阅病历，了解可能解释患者症状的既往下肢疾病或慢性病情况。确定该患者组中经超声诊断为DVT的频率。
双侧出现提示DVT症状的患者未发现DVT。回顾性分析表明，34例（68%）患者存在既往疾病（心脏病、静脉功能不全、慢性肿胀、蜂窝织炎或血栓性静脉炎、外周动脉疾病）。由于压迫超声对DVT诊断的敏感性和特异性均大于90%，因此这些结果具有统计学意义（P <.001）。
双侧下肢出现症状的患者发生DVT的可能性极低。在考虑进行下肢超声检查之前，应仔细探究其他病因。
