下肢静脈血栓:超音波下肢2ポイント法+Dダイマー戦略
2008年 10月 08日
簡易であるTwo-Point StrategyBriefly, the common femoral at the groin and the popliteal vein down to its branching into the calf deep veins at the popliteal fossa were examined in the transverse plane with a linear probe (5-10 MHz). Vein incompressibility was the only diagnostic criterion applied. Test results were categorized as normal (compressible veins) or abnormal (noncompressible veins).
Lensing AW, Prandoni P, Brandjes D; et al. Detection of deep-vein thrombosis by real-time B-mode ultrasonography. N Engl J Med. 1989;320(6):342-345
Heijboer H, Büller HR, Lensing AW, Turpie AG, Colly LP, ten Cate JW. A comparison of real-time ultrasonography with impedance plethysmography for the diagnosis of deep-vein thrombosis in symptomatic outpatients. N Engl J Med. 1993;329(19):1365-1369.
Cogo A, Lensing AWA, Koopman MMW; et al. Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ. 1998;316(7124):17-20.
Serial 2-Point Ultrasonography Plus D-Dimer vs Whole-Leg Color-Coded Doppler Ultrasonography for Diagnosing Suspected Symptomatic Deep Vein Thrombosis
A Randomized Controlled Trial
the Erasmus Study Group
JAMA. 2008;300(14):1653-1659.
Bernardiらは、初回の下肢DVTエピソードを持つ2098名の連続外来患者で、2ポイント超音波(+Dダイマー)とwhole-leg color-coded Doppler超音波と比較
この2方法は、ほぼ同等の検知パフォーマンスであること報告している。
2098名をランダムに2-ポイント(n=1045)と全足(n=1053)超音波検査に割り付け
有症状静脈血栓塞栓
2-ポイント:7/801(発生頻度 0.9%;95%信頼区間[CI], 0.3-1.8%)
全足戦略:9/763(発生頻度;1/2%;95%CI 0.5-2.2%)
これは確立した同等性criterionに合致する(observed difference, 0.3%;95% CI, –1.4% to 0.8%)
insidermedicine
by internalmedicine | 2008-10-08 11:24 | 動脈硬化/循環器