Radiology 2001 May;219(2):498-502
Deep Venous Thrombosis with Suspected Pulmonary Embolism: Detection with
Combined CT Venography and Pulmonary Angiography.
Loud PA, Katz DS, Bruce DA, Klippenstein DL, Grossman ZD.
PURPOSE: To determine the frequency and location of deep venous thrombosis at computed
tomographic (CT) venography after CT pulmonary angiography in a large series of patients
clinically suspected of having pulmonary embolism and to compare the accuracy of CT
venography with lower-extremity venous sonography. MATERIALS AND METHODS: Venous phase
images were acquired from the diaphragm to the upper calves after completion of CT
pulmonary angiography in 650 patients (373 women, 277 men; age range, 18-99 years; mean
age, 63 years) to determine the presence and location of deep venous thrombosis. Results
of CT venography were compared with those of bilateral lower-extremity venous sonography
in 308 patients. RESULTS: A total of 116 patients had pulmonary embolism and/or deep
venous thrombosis, including 27 patients with pulmonary embolism alone, 31 patients with
deep venous thrombosis alone, and 58 patients with both. Among 89 patients with deep
venous thrombosis, thrombosis was bilateral in 26, involved the abdominal or pelvic veins
in 11, and was isolated to the abdominal or pelvic veins in four. In patients in whom
sonographic correlation was available, CT venography had a sensitivity of 97% and a
specificity of 100% for femoropopliteal deep venous thrombosis. CONCLUSION: Combined CT
venography and pulmonary angiography can accurately depict the femoropopliteal deep veins,
permitting concurrent testing for venous thrombosis and pulmonary embolism. CT venography
also defines pelvic or abdominal thrombus, which was seen in 17% of patients with deep
venous thrombosis.
PMID: 11323478
