Duplex Ultrasound in the Diagnosis of Lower-Extremity Deep Venous Thrombosis
A 26-year-old woman presented with progressive swelling and pain of the left leg within 2 months after switching to a different oral contraceptive preparation. On examination, she had marked edema and erythema of the leg from the calf to the thigh with significant tenderness to palpation. Pedal pulses were intact. The right leg was normal. Lower-extremity venous duplex ultrasound (VDUS) with B-mode compression maneuvers and Doppler evaluation was performed, and she was found to have an acute deep venous thrombosis (DVT) of the left leg that extended from the common iliac vein into the left calf (Figure 1A–1E).
Components of the VDUS Examination to Assess for DVT
VDUS combines 2 components to assess for DVT: B-mode or gray-scale imaging with transducer compression maneuvers and Doppler evaluation consisting of color-flow Doppler imaging and spectral Doppler waveform analysis.1 The technique of compression B-mode ultrasonography for the diagnosis of DVT was first described by technologist Steve Talbot in 1982 and has subsequently been refined to become the diagnostic standard.2 B-mode imaging is used while the lower-extremity veins are compressed along their length with the ultrasound probe …