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Is Color-Flow Duplex a Good Diagnostic Test for Detection of Isolated Calf Vein Thrombosis in High-Risk Patients?

Tracey Richardson, RVT

Marshall W. Webster, MD

Michel S. Makaroun, MD

Mark K. Eskandari, MD

Northwestern University Medical School Division of Vascular Surgery Suite 626 Wesley 251 East Chicago Avenue Chicago, IL 60611

Color-flow duplex scanning (CDS) is a good diagnostic test for lower extremity proximal deep vein thrombosis (DVT). This report aims to evaluate the diagnostic accuracy of CDS in detecting isolated calf DVT in two in-hospital populations. A total of 166 patients had routine DVT testing with both CDS and venography: 99 total joint arthroplasty patients and 67 symptomatic in-hospital patients. Isolated calf DVT was noted in 34% of arthroplasty patients and 12% of symptomatic in-hospital patients. Peroneal DVT was most common. The sensitivity, specificity, positive predictive value, and negative predic tive value (with 95% confidence interval [CI]) of CDS in detecting isolated calf DVT in the symptomatic in-hospital group was 39% (16%-62%), 98% (94%-99%), 88% (65%- 99%), and 81% (71%-91%), respectively. In the arthroplasty patients these values were 13% (3%-23%), 92% (85%-99%), 60% (30%-90%), and 55% (45%-65%), respec tively. CDS has a low sensitivity in detecting isolated calf DVT among hospitalized patients and cannot be deemed an effective tool for identifying clots limited to only one or two tibial vessels.

Angiology, Vol. 51, No. 9, 705-710 (2000)
DOI: 10.1177/000331970005100901


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