Comparison of Venography and Ultrasound for the Diagnosis of Asymptomatic Deep Vein Thrombosis in the Upper Body in Children

Christoph Male; Peter Chait; Jeffrey S. Ginsberg; Kim Hanna; Maureen Andrew; Jacqueline Halton; Ron Anderson; Patricia McCusker; John Wu; Thomas Abshire; Irene Cherrick; Donald Mahoney; Lesley Mitchell

doi:10.1055/s-0037-1613054

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2002; 87(04): 593-598
DOI: 10.1055/s-0037-1613054

Review Article

Schattauer GmbH

Comparison of Venography and Ultrasound for the Diagnosis of Asymptomatic Deep Vein Thrombosis in the Upper Body in Children

Results of the PARKAA Study

Christoph Male

¹The Hospital for Sick Children, Toronto

,

Peter Chait

¹The Hospital for Sick Children, Toronto

,

Jeffrey S. Ginsberg

²McMaster University, Hamilton

,

Kim Hanna

³Bayer Inc., Toronto

,

Maureen Andrew

¹The Hospital for Sick Children, Toronto

,

Jacqueline Halton

⁴Children’s Hospital of Eastern Ontario, Ottawa

,

Ron Anderson

⁵Alberta Children’s Hospital, Calgary

,

Patricia McCusker

⁶Children’s Hospital of Western Ontario, London

,

John Wu

⁷British Columbia Children’s Hospital, Vancouver, Canada

,

Thomas Abshire

⁸Emory University School of Medicine, Atlanta

,

Irene Cherrick

⁹University Hospital, Syracuse

,

Donald Mahoney

¹⁰Texas Children’s Hospital, Houston, USA

,

Lesley Mitchell

¹The Hospital for Sick Children, Toronto

› Author Affiliations

Abstract

Summary

Deep vein thrombosis (DVT) in children occurs primarily in the upper body venous system. This prospective diagnostic study compared bilateral venography and ultrasound for detection of DVT in the upper venous system in 66 children with acute lymphoblastic leukemia. Results were interpreted by central blinded adjudication.

Deep venous thrombosis occurred in 29% (19/66) patients. While 15/19 DVT were detected by venography (sensitivity 79%), only 7/19 were detected by ultrasound (sensitivity 37%). The 12 DVT detected by venography but not by ultrasound were located in the subclavian vein or more central veins. Three of 4 DVT detected by ultrasound but not by venography were in the jugular vein. We conclude that ultrasound is insensitive for DVT in the central upper venous system but may be more sensitive than venography in the jugular veins. A combination of both venography and ultrasound is required for screening for DVT in the upper venous system.

Keywords

Deep vein thrombosis - upper body venous system - ultrasound - venography - diagnosis - children

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References

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