Accuracy of three-point compression ultrasound for the diagnosis of proximal deep-vein thrombosis in emergency department

J Res Med Sci. 2019 Sep 30;24:80. doi: 10.4103/jrms.JRMS_1057_18. eCollection 2019.

Abstract

Background: This study aimed to assess the accuracy of three-point compression ultrasonography (3PCUS) performed for the diagnosis of proximal deep-vein thrombosis (DVT) in Emergency Department (ED) compared with the results of duplex US (DUS) (whole-leg compression ultrasound).

Materials and methods: The current prospective cross-sectional study with diagnostic test assessment was conducted on adult patients who were referred to the ED of a general teaching hospital in Shiraz, southern part of Iran (September 2016-May 2017), suspected of lower-extremity DVT, using a convenience sampling. The results of 3PCUS performed by ED residents were compared with the results of DUS performed by the radiology residents, which was considered as a criterion standard.

Results: A total of 240 patients were enrolled, with a mean (standard deviation) age of 59.46 (16.58). 3PCUS has a sensitivity and a specificity of 100% (95% confidence interval [CI], 96.55%-100%) and 93.33% (95% CI, 87.72%-96.91%), respectively, in comparison with DUS (whole-leg compression ultrasound). Negative predictive value and positive predictive value were 100% and 92.11% (95% CI, 86.12%-95.64%), respectively, with an accuracy of 96.25% (95% CI, 93%-98.27%).

Conclusion: The results of this study showed that 3PCUS of the lower extremities with a portable US machine, performed by the ED's residents, can accurately identify the presence or absence of lower-extremity DVT.

Keywords: Compression ultrasound; deep-vein thrombosis; emergency department.