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