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Sonographic Evaluation of Upper Extremity Deep Venous Thrombosis

Department of Radiology, West Los Angeles Veterans Administration Medical Center, Los Angeles, California USA (E.E.C.); Department of Radiology, University of California Los Angeles School of Medicine, Los Angeles, California USA (P.T.Z.); and Department of Radiology, University of Southern California, Keck School of Medicine, University of Southern California University Hospital, Los Angeles, California USA (E.G.G.).

Address correspondence to Eva E. Chin, MD, Department of Radiology, West Los Angeles Veterans Administration Medical Center, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. E-mail: evachin{at}aol.com

Objective. The purpose of this presentation is to review the techniques of performing an upper extremity Doppler examination, in addition to illustrating the sonographic appearances of acute and chronic upper extremity deep venous thrombosis (UEDVT). Methods. The risk factors and complications of UEDVT are discussed, and the anatomy of the upper extremity deep venous system as well as examination techniques are described. Cases of acute and chronic deep venous thrombosis were also chosen to illustrate the spectrum of sonographic appearances. Results. Color Doppler sonography is accurate in the diagnosis of UEDVT. However, in cases of equivocal Doppler findings, or when the sonographic findings are normal but clinical suspicion for central venous thrombosis is high, magnetic resonance or contrast venography is necessary for further evaluation. Conclusions. Color Doppler sonography is a rapid and noninvasive technique in the evaluation of venous disease in the upper extremity and is the modality of choice in screening for UEDVT.

Key Words: Doppler sonography • upper extremity • venous thrombosis

Abbreviations: MR, magnetic resonance • PICC, peripherally inserted central catheter • UEDVT, upper extremity deep venous thrombosis

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