The clinical diagnosis of DVT is not accurate: it has, in fact, a low sensitivity/specificity because even extended thrombosis may be clinically silent and symptoms/signs of DVT are also present in different diseases.
Early and reliable diagnosis, however, is required: the patient with DVT must be treated urgently and properly to prevent pulmonary embolism, recurrent DVT and to prevent post-thrombotic syndrome.
In the case of suspected DVT the diagnostic strategies are different depending on the type of patient (ambulatory or hospitalized, symptomatic or asymptomatic). In particular, the diagnostic strategies include: the determination of the pretest clinical probability (Wells score), the D-dimer test, and the ultrasound diagnosis.
In this lesson the diagnostic strategies in different types of patients will be presented together with the role, within the different algorithms, of the simplified compression ultrasound (s-CUS) and of the complete compression ultrasound (c-CUS)/complete ecocolor Doppler study.
Franco Accorsi, MD
Member of the Order of Physician of Bologna n° 6728
I am a specialist in Medical Angiology and I am based in Bologna, Italy. Until 2008 (voluntary resignation) I worked at Maggiore Hospital in Bologna as "Dirigente Medico" in the Department of Internal Medicine and as Angiologist in the Angiology Unit with a position of "Alta Professionalità" in "Vascular Ecography and Angiology".
I am currently working in Bologna as an independent professional in the areas of angiology and vascular diagnostics.
I have been a speaker at national and international courses/congress and I have taught duplex ultrasound method in GIUV and SIUMB courses at the Maggiore Hospital, Bologna and courses of echocolor Doppler of extracranial and intracranial arteries at the Stroke Unit of S. Maria Nuova Hospital, Reggio Emilia.