Sheiman R G, McArdle C R
Department of Radiology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215.
Radiology. 1995 Jan;194(1):171-3. doi: 10.1148/radiology.194.1.7997546.
To assess the need for bilateral ultrasound (US) evaluation for lower extremity deep venous thrombosis (DVT) regardless of predisposing factors in patients with unilateral symptoms.
Two hundred six patients with unilateral lower extremity symptoms suggestive of DVT were evaluated prospectively for predisposing factors and symptoms. Bilateral examinations were performed in all patients, and the prevalences of US-diagnosed DVT in symptomatic and in asymptomatic extremities were determined.
Thirty-seven of the 206 patients had DVT in the symptomatic extremity. Twenty-five of these 37 patients had predisposing factors. No DVT was found in any asymptomatic extremity. Because compression US has a sensitivity and a specificity of greater than 90% for the diagnosis of DVT, these results were statistically significant (P < .001).
Regardless of predisposing factors, US screening for DVT in the lower extremities should be limited to the symptomatic extremity in patients with unilateral symptoms. This would decrease scanning time and cost without a decline in the DVT detection rate.
评估对于有单侧症状的患者，无论其是否存在易患因素，是否需要对下肢深静脉血栓形成（DVT）进行双侧超声（US）评估。
对206例有单侧下肢DVT症状的患者进行前瞻性评估，以确定其易患因素和症状。所有患者均进行双侧检查，并确定有症状和无症状肢体中经超声诊断的DVT患病率。
206例患者中有37例在有症状的肢体中发生DVT。这37例患者中有25例存在易患因素。在任何无症状肢体中均未发现DVT。由于压迫超声诊断DVT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 < 0.001）。
无论有无易患因素，对于有单侧症状的患者，下肢DVT的超声筛查应仅限于有症状的肢体。这将减少扫描时间和成本，而不会降低DVT的检出率。
