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What study should we be getting to evaluate for DVT in patients with suspected VTE (venous thromboembolic disease)?
Ultrasound of the legs seems to be equivalent to CT Venography (CTV).
Drawbacks of CT Venography (CT scanning into the abdomen/pelvis/legs after pulmonary CTPA):
- Radiation (TONS of radiation!)
- Cost
- Never been proven superior to non-invasive ultrasound
Despite the fact that leg ultrasound obviously doesn't evaluate for deep pelvis clots and intraabdominal clots (IVC, etc), outcome studies and other studies in recent years show ultrasound is just as good as CTV.
References
Goodman LR, et al. CT Venography and Compression Sonography are Diagnostically Equivalent: Data from PIOPED II. Am J Roent 2007