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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:885-891 • 0278-4297

The Importance of Monophasic Doppler Waveforms in the Common Femoral Vein

A Retrospective Study

Edward P. Lin, MD, Shwetta Bhatt, MD, Deborah Rubens, MD and Vikram S. Dogra, MD

Department of Imaging Sciences, University of Rochester School of Medicine, Rochester, New York USA.

Address correspondence to Vikram S. Dogra, MD, Department of Imaging Sciences, University of Rochester School of Medicine, 601 Elmwood Ave, Box 648, Rochester, NY 14642 USA. E-mail: vikram_dogra{at}urmc.rochester.edu

Objective. The purpose of this study was to assess the importance of monophasic waveforms encountered in the common femoral vein during deep venous thrombosis evaluation by a retrospective review of lower extremity venous Doppler (VD) sonography and correlative studies, such as computed tomography (CT) and magnetic resonance imaging. Methods. A retrospective review was conducted of lower extremity VD studies performed from September 1, 2000, through September 1, 2005. All satisfactory VD studies, which were in compliance with the Intersocietal Commission for the Accreditation of Vascular Laboratories standard protocol, were evaluated for the presence of monophasic waveforms and correlated with CT of the abdomen and pelvis. Studies were evaluated for the causes of monophasic waveforms. Patients younger than 18 years were excluded. Results. A total of 2963 VD examinations were reviewed. One hundred twenty-four of 2963 showed monophasic waveforms. Eighty-nine of the 124 had additional CT examinations within 1 week; 19 had CT within 2 months; and 16 had no additional examinations. Forty-seven of 124 cases revealed deep venous thrombosis extending into the iliac veins, of which 23 were identified by VD sonography; 26 were due to extrinsic compression; 6 showed a hypoplastic or stenosed common iliac vein; and the remaining 45 had no apparent causes for the monophasic waveforms. Conclusions. Monophasic waveforms in the common femoral veins are reliable indicators of proximal venous obstruction. Because iliac vein thrombosis is clinically important, we recommend routine sonographic evaluation of external iliac veins in the presence of monophasic waveforms and CT or magnetic resonance imaging, if necessary, to determine the cause of the monophasic waveforms.

Key Words: color flow Doppler sonography • deep venous thrombosis • monophasic waveforms • sonography

Abbreviations: CT, computed tomography • DVT, deep venous thrombosis • IVC, inferior vena cava • MRI, magnetic resonance imaging • PE, pulmonary embolism • VD, venous Doppler

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.