Thermography in the Diagnosis of DVT

 

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Summary

161 consecutively admitted medical patients with the clinical suspicion of acute deep venous thrombosis (DVT) were thermographed and phlebographed in order to study the congruence of these methods. The sensitivity of thermography in the detection of DVT was found to be 99%, whereas the specificity was only 49%.

The low specificity is explained by the fact that all thermographs suggestive of DVT were classified as pathologic to keep the sensitivity of the method as high as possible. Patients with dilated veins which may closely resemble DVT on thermography may in these cases give false positive results.

Of 76 patients with phlebographically verified DVT, 22% became thermographically normal within 22 days, whereas 78% did not normalize within the mean observation time of 31 days.

In another part of the study all medical patients (101) who were residing in our wards during a period of a week were screened by means of thermography. From this unselected group 17 patients were found to have thermographs suggestive of DVT. In 5 of these patients no reason for pathological thermography could be found.

Thermography is a cheap and highly sensitive screening method for DVT, but findings of false positives caused by older thromboses and dilated veins are not unusual. The frequency of such false positives may be minimized by performing thermography after exercise.

• References

• 1 Cooke ED, Pilcher MF. Thermography in diagnosis of deep vein thrombosis. Br Med J 1973; 2: 523-526
  CrossrefPubMedGoogle Scholar
• 2 Bergqvist D, Efsing HO, Hallbòòk T. Thermography. A non-invasive method of diagnosis of deep venous thrombosis Arch Surg 1977; 122: 600-604
  PubMedGoogle Scholar
• 3 Byström LG, Larsson T, Lundell L, Åbom PE. The value of thermography and the determination of fibrinogen degradation products in the diagnosis of deep venous thrombosis. Acta Med Scand 1977; 202: 319-322
  PubMedGoogle Scholar
• 4 Watz R, Ek I, Bygdeman S. Non-invasive diagnosis of acute deep vein thrombosis. A comparison between thermography, plethysmography and phlebography Acta Med Scand 1979; 206: 463-466
  PubMedGoogle Scholar
• 5 Ritchie WG M, Soulen RL, Lapayowker MS. Thermographic diagnosis of deep venous thrombosis. Radiology 1979; 131: 341-344
  CrossrefPubMedGoogle Scholar
• 6 Eliasen P, Brünner S. Termografi til diagnose af dyb vene thrombose pà underekstremiteterne. Ugeskrift for Laeger 1980; 142: 689-691
  PubMedGoogle Scholar
• 7 Lockner D, Hedlund B, Nyman D, Paul C. Termografisk diagnostik av djup ventrombos. p 166 Proceedings of the Swedish Medical Association; Stockholm: 1978
  Google Scholar
• 8 Lockner D, Hedlund B, Paul C, Nyman D, Schulman S. Thermography in the diagnosis of DVT. Proceedings of the VII:th International Congress of Phlebology; P 75 Copenhagen: 1980
  Google Scholar
• 9 Williams WJ. Venography. Circulation 1973; 47: 220-221
  CrossrefPubMedGoogle Scholar
• 10 Cooke ED. The fundamentals of thermographic diagnosis of deep vein thrombosis. Acta Thermographica. 1978 suppl 1
  PubMedGoogle Scholar
• 11 Cooke ED, Pilcher MF. Deep vein thrombosis: Preclinical diagnosis by thermography. Br J Surg 1974; 61: 971-978
  CrossrefPubMedGoogle Scholar
• 12 Hallböök T, Lind L. Resting blood flow at deep venous thrombosis of the leg. Acta Chir Scand 1972; 138: 581-584
  PubMedGoogle Scholar
• 13 Nylander G, Olivecrona H. The phlebography pattern of acute leg thrombosis within a defined urban population. Acta Chir Scand 1976; 142: 505-511
  PubMedGoogle Scholar