This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rubin, J. M. Articles by O’Donnell, M. Search for Related Content PubMed PubMed Citation Articles by Rubin, J. M. Articles by O’Donnell, M.

Sonographic Elasticity Imaging of Acute and Chronic Deep Venous Thrombosis in Humans

University of Michigan, Ann Arbor, Michigan USA (J.M.R., K.K., W.F.W., T.W.W., A.G.U., M.O.); Philips Medical Systems, Bothell, Washington USA (H.X.); and University of Texas at Austin, Austin, Texas USA (S.Y.E., S.R.A.).

Address correspondence to Jonathan M. Rubin, MD, PhD, Department of Radiology, University of Michigan Hospitals, 1500 E Medical Center Dr, Ann Arbor, MI 48109 USA. E-mail: jrubin{at}umich.edu

Objective. The purpose of this study was to assess the ability of sonographic elasticity imaging to distinguish acute from chronic deep venous thrombosis (DVT). Methods. Fifty-four patients, 26 with acute DVT and 28 with chronic DVT, were studied, and we analyzed the data in 46 patients, 23 with acute (mean age, 5.7 days) and 23 with chronic (>8 months) DVT. Scanning was performed with a 5-MHz linear array transducer during continuous freehand external deformation of each thrombus using the ultrasound scan head. The strains in the thrombi were normalized to the average strain between the skin surface and the back wall of the vein. Relative thrombus echogenicity was measured by comparing the echogenicity of the thrombus with that of the adjacent arterial lumen. Statistical analyses were performed with the Mann-Whitney U test and receiver operating characteristic analysis. Results. The median normalized strain magnitude for the acute cases was 2.75, with an interquartile range of 2.4 to 3.71, whereas the median normalized strain magnitude for the chronic cases was 0.94, with interquartile range of 0.48 to 1.36. The difference was highly significant (P < 10^–7). The area under the receiver operating characteristic curve (A_z) was 0.97 ± 0.02 (SE). The echogenicity difference between the populations was highly significant (P < 10^–5), with A_z of 0.92 ± 0.04. The difference between the A_z values was not significant (P > .05). Conclusions. In this population, sonographic elasticity imaging performs at least as well as thrombus echogenicity. Thrombus aging using elasticity imaging would be particularly helpful in evaluating symptoms in patients with post-thrombotic syndrome.

Key Words: deep venous thrombosis • elastography • sonographic elasticity imaging • strain imaging

Abbreviations: DVT, deep venous thrombosis • IQ, in-phase and quadrature • IQR, interquartile range • ROC, receiver operating characteristic • 2D, 2-dimensional

This article has been cited by other articles:

				J. Shao, J. Bai, L. Cui, J. Wang, Y. Fu, K. Liu, and S. Feng Elastographic Evaluation of the Temporal Formation of Ethanol-Induced Hepatic Lesions: Preliminary In Vitro Results J. Ultrasound Med., September 1, 2007; 26(9): 1191 - 1199. [Abstract] [Full Text] [PDF]

				R. C. Booi, P. L. Carson, M. O'Donnell, M. S. Richards, and J. M. Rubin Diagnosing Cysts With Correlation Coefficient Images From 2-Dimensional Freehand Elastography J. Ultrasound Med., September 1, 2007; 26(9): 1201 - 1207. [Abstract] [Full Text] [PDF]