The aim oj this work is to evaluate some new diagnostic modalities; D¬dimer test, Duplex imaging and MR venography; Jor Deep Venous Throm¬bosis (DVT).
Thirty patients were included in this study with clinically suspected DVT. Full history taking and thorough clinical examination together with routin laboratory investigation. resting ECG. Trans-thoracic Echo-Doppler. Murex D-dimer test and Duplex imaging were done Jor all patients. MR ve¬nography . was done only Jor the 16 cases with the clinical pretest inter¬mediate probability Jor DVT.
The results oj the present study showed that 20 cases showed posi¬tive Duplex. 7 with popliteal. 7 Jemoral and 6 cases withJemoral and pop¬liteal DVT.
19 cases showed positive D-dimer test Vs 11 with negative test.
The 16 cases subjected to MR venography showed results coincide with sam~ findings as Duplex apart from 3 cases in which soleal and ilial DVT not detected by Duplex study.
Conclusion: From the results it was Jound that:
Duplex ultrasonography is now considered the diagnostic modality oj choice in evaluation oj the venous system oj lower limbs. 8ecause oj its safety. accuracy. high specificity and sensitivity and its availability. all these makes it a modality oj choice.
D-dimer test, is specific degradatiqn product oj fibrin. in our study and other studies have shown its high sensitivity moderate specificity and
Khaled El-Rabbat et al ...
high negative predictive valueJor suspected deep vein thrombosis. Its val¬ue varies from one study to another according to the type oj D-dimer as¬say used in the study. When D-dimer test combined with clinical pretest probability its negative predictive value is markedly increased up to 100%.
MR venography and Duplex sonography have beenJound to be identi¬calJor evaluation oj DVf in venous •system as regard oj popliteal andJe¬moral veins, but it is superior to Duplex study in evaluating venous sys¬tem oj the pelvis and iliac veins. Its availability, lack oj operator experience and its cost limit its application.
Recommendation:
Duplex ultrasound is the diagnostic modality oj choice Jor DVf oj lower limbs and MR venography is preJerable only in selected cases.
D-dimer test when combined with clinical probability is a good nega¬tive test which can reduced the needJor Duplex imaging.
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