Diagnóstico de las Trombosis Venosas en Ecocrafía Dúplex

Jorge Picorel, Daniel Antonio Vives, Eduardo Gómez Gimenez

Resumen


La Ultrasonografía constituye en la actualidad el método de elección en el estudio de un paciente con sospecha de Trombosis Venosa Profunda (TVP), habiendo desplazado a la Flebografía del primer lugar en el diagnóstico y a otros métodos como la Pletismografía y la Gammagrafía. Esto es así debido a su gran confiabilidad, sensibilidad y especificidad, así también por ser fundamentalmente no invasivo. No provoca molestias al paciente tales como dolor, ni tampoco lo somete al riesgo de la reacción alérgica al contraste yodado, siempre latente, ni a la flebitis química inducida por el mismo.
Cuando la TVP es diagnosticada clínicamente ésta está presente  en menos del 50% de las veces; y en sólo el 3% de las muertes hospitalarias en las que se comprobó TVP en la autopsia, el diagnóstico fue hecho antes de la muerte.

Por estas razones habría que investigar con un criterio objetivo aquellos pacientes con sospecha de TVP e intensificar su búsqueda en aquellas situaciones que implican alto riesgo de desarrollarla (Pacientes con fracturas de cadera, coagulopatías, embarazos, postquirúrgicos, neoplasias, etc).


Palabras clave


ultrasonografía; trombosis venosa; técnica; indicaciones

Texto completo:

9-25

Referencias


Cronan JJ. Ultrasound evaluation of deep venous thrombosis. Semin-Roentg, Vol. XXVII, N 1 (Jan), 1992: pp 39-52.

LOng A, Vitoux JF, Martelli L, Fiessinger JN. Thrombosis of the gastrocnemic. A clinical entity. Presse-Med; 1990 Jun 9; 19 (23); P 1081-3.

Franco G. Ultrasonics and deep vein thrombosis. Ilio-caval level and the lower extremities. Phlebologie; 1988, Jan-Mar; 41(1); P 187-204.

Robbins SL. Patología Humana. 3º Ed. Editorial Panamericana 1986, P 67-73.

Raghavendra BN, Horii SC, Hilton S, etal.: Deep venous thrombosis: Detection by probe compresion of veins. J. Liltrasound Med 1986; 5; P 89-95.

PolakJF: Doler ultrasound of thedeep legveins. A revolutiqnin the diagnosis of deep vein thrombosis and monitoring of thrombolysis. Chest; 1991 Apr; 99 (4 Suppl); P 165S-172S.

Habscheid W; Landwehr P: diagnosis of acute deep leg vein thrombosis with compression ultrasonography. Ultraschall-Med; 1990 Dec; 11(6); P 268-73.

Yucel EK; Fisher JS; Egglin TK Geller SC; Waltman AC: Isolated calf venous thrombosis: diagnosis with compression US. Radiology; 1991 May; 179 (2); P 443-6.

Biondett PR; Vigo M Tomasella G; Prnadoni P: Diagnosis of deep venous thrombosis of the legs: accuracy of ultrasonography using vein compression. Radiol-Med-(Torino); 1990 Oct; 80 (4); P 463-8.

MussurakisS; PapaioannouS; VorosD; Vrakatselis T: Compression ultrasonography as a rehable imaging monitor ¡o deep venous thrombosis. Surg-Gynecol-Obstet; 1990 Sep; 171(3); P 233-9.

Habscheid W; Hohmann M; Klein S: compression sonography as a procedure in the diagnosis of acute deep venous thrombosis of the Ieg. Med-Klin; 1990 Jan 15; 85(1); P 6-12.

Froehhich JA; Dorfman GS; Cronan JJ; Urbanek PJ; Herndoni JH; Aaron RK: Compression ultrasonography for the detection of deep venous thrombosis in patients who have a fracture of the hip. A prospective study. J-Bone-Surg [Am]; 1989 Feb; 71(2); P 249-56.

Lensing AW; Prandoni P; Branjes D; Huisinan PM; Vigo M; Tomasella O; Krekt J; Woutcr Ten Catei; Huisman MV; BullerHR: Detection of deep-vein thrombosis by real-time B-mode ultrasonography [see comments]. N-Engl –J Med; 1989 Feb, 9; 320 (6); P 342-5.

O’Leary DH; Kane RA; Chase BM: A prospective study of the efficacy of B-scan sonography in the detection of deep venous thrombosis in the lower extremities. JCIJ; 1988 Jan; 16(1); P 1-8.

Croñan JJ; Dorfman OS; Grusmark J: Lower extremity deep venous thrombosis: further experience with and refinements of US assessment. Radiology; 1988 Jul; 168(1); P 101-7.

Langsfeld M; Flershey FB; Thorpe L; Auer AI; Binnington HB; Hurley JJ; Woods JJ: duplex B mod imaging for the diagnosis of deep venous thrombosis. Arch-Surg; 1987 May; 122 (5); P 587-91.

Appelman PT; De Jong TE; Lampmann LE: Deep venous thrombosis of the leg: US findings. Radiology; 1987 Jun; 163 (3); P 743-6.

Cronan JJ; Dorfman OS; Scola FH; Schepps B; Alexander J: Deep venous thrombosis: US assessment using vein compression. Radiology; 1987 Jan; 162(1 PL 1): P 191-4.

Habscheid W; Hohmann M; WiIhelmT; Epping J: Real-time ultrasound in the diagnosis of acute deep venous thrombosis of the lower extremity. Angiology; 1990 Aug; 41(8); P 599- 608.

Scheffler P; Leipnitz G; Braun B; Jung F; De Lahamette D; Kramann B; Wenzel E: Thrombus formation in deep venous thrombosis. A clinical approach to diagnosis and control of lysis efficacy. Int-Angiol; 1988 Jul-Sep; 7 (3); P 207-13.

Vaccaro JP; Cronan JJ; Dorfman GS: Outcome analysis of patients with normal compression US examinations. Radiology; 1990 Jun; 175 (3); P 645-9.

Prandoni P; Lensing AW: New developments in noninvasive diagnosis of deep vein thrombosis of the lower limbs. Ric-Chin-lab; 1990 Jan- Mar; 20(1); P 11-7.

White RH; McGahan JP; Daschbach MM; Harthing RP: Diagnosis of deep-vein thrombosis using duplex ultrasound [see comments]. Ann-Intern-Med; 1989 Aug 15; 111(4); P 297- 304.

Persson AV; Jones C; Zide R; Jewell ER: Use of the triplex scanner in diagnosis of deep venous thrombosis. Arch-Surg; 1989 May; 124 (5); P 593-6.

Weissleder R; Elizondo O; Stark DD: Sonographic diagnosis of subclavian and internal jugular vein thrombosis. J-Ultrasound-Med; 1987 Oct; 6(10); P 577-87.

Baxter GM; Duffy P; Mackechnie S: Colour Doppler ultrasound of the post-phlebitic limb: sounding a cautionary note. Clin-Radiol; 1991 May; 43 (5); P 301-4.

Murphy TP; Cronan JJ: Evolution of deep venous thrombosis: a prospective evaluation with US. Radiology; 1990 Nov; 177(2); P543- 8.

Gaitini D; Kaftori 1K; Pery M; Narkeh A: Late changes in veins after deep venous thrombosis: ultrasonographic findings. ROFO; 1990 Jul; 153 (1); P 68-72.

Redman HC: Deep venous thrombosis is contrast venography stiII the diagnostic “gold standard” [editorial]. Radiology; 1988 Jul; 168(1); P 277-8.

de Valois JC; van /schaik CC; Verzijibergen F; van Ramshorst B; Eikelboom BC; Meuwissen OJ: Contrast venography: from gold standard to “golden backup” in clinically suspected deep vein thrombosis. Eur-J-Radiol; 1990 Sep-Oct; 11(2); P 131-7.

Rollins DL; Semrow CM; Friedell ML; Calligaro KD; Buchbinder D: Progress in the diagnosis of deep venous thrombosis: the efficacy of real - time B-mode ultrasonic imaging. J-Vasc-Surg; 1988 May; 7 (5); P 638-41.

Fletcher JP; Kershaw LZ; Barker DS; Koutts J; Varnava A: Ultrasound diagnosis of lower 11mb deep venous thrombosis. Med-J-Aust; 1990 Oct 15; 153 (8); P 453-5.

Naidich JB; Feinberg AW; Karp-Harman FI; Karmel MI; Tyma CG; Stein FIL: Contrast venography: reassessment of its role. Radiology; 1988 Jul; 168 (1); P 97-100.

Vogel P; Laing FC; Jeffrey RB Jr; Wing VW: Deep venous thrombosis of the Iower extremity: US evaluation. Radiology; 1987 Jun; 163 (3); P 747-51.

Skillman JJ; Kent KC; Porter DH; Kim D: Simultaneous occurrence of superficial and deep thrombophlebitis in the lower extremity. J Vasc-Surg; 1990 Jun; II P818-23; discussion 8.

Konradsen L; Jorgensen LN; Albrecht-Beste E; Nielsen SP: Popliteal valve incompetence and postoperative deep vein thrombosis. Acta-Chir Scand; 1990 Jun-Jul; 156 (6-7); P 441-3.

Furst G; Kuhn FP; MOdder U: Color-coded Doppler sonography of deep venous thrombosis —possibilities and limitations in the area of the veins of the pelvis and the lower leg including postthrombotic changes (Abstract). Rontgenblatter; 1990 May; 43(5); P 195-202.

Baxter GM; Mc Kechnic S; Duffy P: Colour Doppler ultrasound in deep venous thrombosis: a comparison with venography. Clin-Radiol; 1990 Jul; 42(1); P32-6.

Rose Sc; Zwiehel WJ; Nelson BD; Priest DL; Knighton RA; Brown JW; Lawrence PF; Stelts BM; Reading JC; Miller FJ: Symptomatic lower extremity deep venous thrombosis: accuracy, limitations, and Radiology; 1990 Jun; 175 (3); P 639-44:

van Bemmclen PS; Bedford G; Strandness DE: Visualization of calf veins by color flow imaging. Ultrasound-Med-Biol; 1990; 16(1); P 15- 7.

Furst G; Kuhn FP; Trappe RP; Modder U: The diagnosis of deep venous thromboses of the leg. Color-Doppler sonography versus phlebography (Ab). ROFO; 1990 Feb; 152 (2); P 15 1-8.

Miselli A; larini P; Mandrioli R; Ugolotti U; Marcato C; Quintavalla R: Ultrasonography in the diagnosis of deep venous thrombosis of the legs (Ab). Radiol-Med-(Torino); 1990 Oct; 80 (4); P 469-73.

Wright Di; Shepard AD; McPharlin M; Ernst CB: Pitfalls in lower extremity venous duplex scanning. J-Vasc-Surg; 1990 May; 11 (5); P 675-9.

HuIl Rd; Hirsh J; Carter CH et al: Pulmonary angiography, ventilation lung scanning, and venography for clinical y suspected pulmonary embolism with abnormal perfusion lung scan. Ann lntrn Med 98: 89 1-899, 1983.

Foley WD; Middleton WD; Lawson TL; Erickson S; Quiroz FA; Macrander S: Color Doppler ultrasound imaging of lower-extremity venous disease. AJR-Am-J-Roentgenol; 1989 Feb; 152(2); 1,371-6.

Perlin SJ: Pulmonary embolism during compression US of the Lower Extremity. Radiology; 1992 Jul; 184: 165-166.

Williams (‘E; Lamb Gil; Roberts D; Davies .1: Venous thrombosis in the neck. The role of real time ultrasound (Ab). Eur-J-Radiol; 1989 Feb; 9(1); 1’ 32-6.

Horattas MC; Wright DJ; Fenton AH; Evans DM; Oddi MA; Kamiensky RW; Shields EF: Changing Concepts of deep venous thrombosis of the upper extremity - Report of a series and review of the literature. Surgery; 1988 Sept; 104: 561-7.

Rupar DG; Herzog KD; Fisher MC; Long SS: Prolonged bacteremia with catheter—related central venous thrombosis (Ab). Am-J-Dis-Child; 1990 Aug; 144 (8); P 879-82.

Baxter BT; Blackburn D; Payne K; Pearce WH; Yao JS: Noninvasive evaluation of the upper extremity. Surg-Clin-North-Am; 1990 Feb; 70 (1): P 87-97.

Knudson GJ; Wiedmeyer DA; Erickson SJ; Foley WD; Lawson TL; Mewissen MW; Lipchik EO: Color Doppler sonographic imaging in the assessment of upper-extremity deep venous thrombosis. AJR—Am—l—Roentgenol; 1990 Feb; 154 (2); P 399-403.

Grassi CJ; Polak JF: Axillary and subclavian venous thrombosis: follow-up evaluation with color Doppler flow US and venography. Radiology; 1990 Jun; 175 (3); P 65 1-4.

Rosenfeld JC; Estrada FP; Orr RM: Management of deep venous thrombosis in the pregnant female (Ab). J. Cardiovasc. Surg. (Torino); 1990 Sept-Oct; 31(5); P 678-82.

Greer IA; Barry J; Mackon N; Allan PL: ZDiagnosis of deep venous thrombosis in pregnancy: a new role for diagnostic ultrasound (Ab). Br-J-Obstet-Gynaecol; 1990 Jan; 97 (1); P 53-7.

Abbit PL; Thiagarajah S: Venous sonography for pregnancy-related thrombosis: case report (Ab). Va-Med; 1989 Jun; 116 (6); P 277-8.

Frede TE; Ruthberg BN: Sonographic demonstration of iliac venous thrombosis in the maternity patient. J-Ultrasound-Med; 1988 Jan; 7 (1); P 33-7.

Polak JF; O’Leary DH: Deep venous thrombosis in pregnancy: noninvasive diagnosis. Radiology; 1988 Feb; 166 (2); P 377-9.

Sohn C; Rudofsky G; Swobodnik W; Karl C: Non-invasive diagnosis of the venous system of the leg in pregnancy (Ab). Ultraschall-Med; 1987 Dec; 8 (6); P 263-7.

Cronan JJ; Froehlich JA; Dirfman GS: Image directed Doppler Ultrasound: a Screening technique for patient at hide risk to develop deep vein thrombosis. JCU; 1991 Mar-Apr; 19(3); P 133-8.

Borris LC; Christiansen HM; Lassen MR; Olsen AD; Schott P: Real-time B-mode ultrasonography in the diagnosis of postoperative deep vein thrombosis in non-symptomatic high-risk patients. The Venous thrombosis Group (Ab). Eur. J. Vasc. Surg.; 1990 Oct; 4(5); P 473-5.

Monreal M; Lafoz E; Casals A; Inaraja L; Montserrat E; Callejas JM; Martorell A: Occult cancer in patients with deep venous thrombosis. A systematic approach. Cancer; 1991 Jan 15; 67 (2); P 541-5.

Elorza CA; Lo Vuolo ME; PastorSR: Gamuts en Ecografía. Tomo 1, 1987, Ed. Científica Americana; P. 74-78.

Cecil, Wyngarden, Smith: Tratado deMedicina Interna. 18 Edición, Vol. 1, 1991, Interamericana McGraw-Hill; P. 1219.

Endo M; Sato H; Murakami S; Kidani M; Noto T: A case of pseudothromhophlehitis due to inguinal synovial cyst. Am-Surg; 1990 Sep; 56 (9); P 533-4.

Quinn KL; Vandeman FN: Thrombosis of a duplicated superficial femoral vein. Potential error in compression ultrasound diagnosis of lower extremity deep venous thrombosis. J-Ultrasound-Med; 1990 Apr; 9 (4); P 235-8.

Aitken AG; Godden DJ: Real-time ultrasound diagnosis of deep vein thrombosis: a comparison with venography. Clin-Radiol; 1987 May; 38 (3); P 309-13.

Johnsen FM; Andersen G: Diagnosis of popliteal cyst and their complication (Ab). Ugeskr Laeger; 1991 Feb 11; 153 (7); P 517-8.

Scola FH; Parzialei R: Ultrasonographic diagnosis of heterotopic ossification mimicking deep vein thrombosis. JCU; 1991 Jan; 19(1); P 55-7.

Pignatelli V; Savino A; Orsitto E; Kiferle M; Ruiu U: Echographic study of the popliteal region (Ab). Minerva-Chir; 1989 Nov 15; 44 (21); P 2245-50.

Liu JB; Merton DA; Mitchell DG; Needleman L; Kurtz AB; Goldberg BB: Color Doppler imaging of the iliofemoral region. Radiographics; 1990 May; 10(3); P 403-12.


Enlaces refback



Copyright (c) 2019 Jorge Picorel, Daniel Antonio Vives, Eduardo Gómez Gimenez



Asociación Médica de Bahía Blanca - Castelli 213 - B8000AIE Bahía Blanca - Buenos Aires - Argentina - https://www.ambb.org.ar