Ultrasound elastography may distinguish between acute and chronic DVT

Ultrasound elastography (UE) imaging appears to be a promising technique for distinguishing between acute and chronic deep vein thrombosis (DVT), according to a new study published in the Journal of Thrombosis and Haemostasis.

UE imaging is a novel sonographic technique that is commonly employed for relative quantification of tissue elasticity. Its applicability to venous thromboembolic events has not yet been fully established; in particular, it is unclear whether this technique may be useful in determining the age of DVT.

Nicola Mumoli, Department of Internal Medicine, Ospedale Civile Livorno, Viale Alfieri Livorno, Italy, and colleagues conducted the study to assess the role of UE in distinguishing acute from chronic DVT.

For the study, the authors analyzed consecutive patients with a first unprovoked acute and chronic (3 months old) DVT of the lower limbs. Patients with recurrent DVT or with a suspected recurrence were excluded. The mean elasticity index (EI) values of acute and chronic popliteal and femoral vein thrombosis were compared. The accuracy of the EI in distinguishing acute from chronic DVT was also assessed by measuring the sensitivity, specificity, positive and negative predictive values, and likelihood ratios.

• The mean EI of acute femoral DVT was higher than that of chronic femoral DVT (5.09 versus 2.46), and the mean EI of acute popliteal DVT was higher than that of chronic popliteal DVT (4.96 versus 2.48).


• An EI value of > 4 resulted in a sensitivity of 98.9% (95% confidence interval [CI] 93.3–99.9), a specificity of 99.1% (95% CI 94.8–99.9), a positive predictive value of 91.1% (95% CI 77.9–97.1), a negative predictive value of 98.6% (95% CI 91.3–99.9), a positive likelihood ratio of 13.23 (95% CI 93–653) and a negative likelihood ratio of 0.001 (95% CI 0.008–0.05) for acute DVT.

"UE appears to be a promising technique for distinguishing between acute and chronic DVT. Larger prospective studies are warranted to confirm our preliminary findings," concluded the authors.