Document Detail


The diagnosis of deep venous thrombosis using laser Doppler skin perfusion measurements.
MedLine Citation:
PMID:  11162195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Compression ultrasonography (CUS) falls short in the diagnosis of deep venous thrombosis in asymptomatic patients and thrombi limited to the calf veins. Alternatively, laser Doppler fluxmetry (LDF) may be useful for this purpose, as it can measure the peripheral vasoconstriction response upon an increase in venous pressure, which is hypothetically preactivated upon venous damming by a thrombus. We investigated the merits of LDF in the diagnosis of DVT. In 81 outpatients, referred with clinically suspected unilateral DVT, skin perfusion in the symptomatic and contralateral legs was measured in the big toe by measuring resting flux (RF) before and during an increase in venous pressure by inflating an ankle cuff to 50 mm Hg. The percentage of LDF reduction (LDFr) was used as a parameter to detect DVT and compared with an independent gold standard (a combination of CUS, D-dimer testing, and 3-month clinical follow-up). The prevalence of DVT was 31%. LDFr in symptomatic legs with DVT [24%; interquartile range (IQR) 8-44%] was significantly (P < 0.001) lower than in symptomatic legs without DVT (60%; IQR 44-70%). Assessment of the diagnostic accuracy of LDF yielded an area under the ROC curve of 0.79. The optimum cutoff value resulted in a sensitivity and a specificity of 80 and 72%, respectively. LDFr is reduced in legs with DVT, supporting the hypothesis of preactivation of the peripheral vasoconstriction response. The diagnostic value of LDF measurements is not likely to surpass that of CUS in symptomatic patients, but may be of additional use in situations where CUS is less sensitive.
Authors:
J C de Graaff; D T Ubbink; H R Büller; M J Jacobs
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Microvascular research     Volume:  61     ISSN:  0026-2862     ISO Abbreviation:  Microvasc. Res.     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-07-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0165035     Medline TA:  Microvasc Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-55     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Humans
Laser-Doppler Flowmetry
Middle Aged
Skin
Thrombophlebitis / diagnosis*

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