Doppler ultrasound and D-dimer

Summary

The diagnosis of venous thromboembolism has evolved considerably with the development of standardized diagnostic algorithms that include clinical probability assessment, D-dimer measurement and the use of non-invasive imaging modalities such as compression ultrasonography and computed tomography angiography. The implementation of these strategies aims to improve resource allocation and patient outcome. The judicious use of these diagnostic tools requires a thorough knowledge of the appropriate clinical setting in which every test and strategy is efficient and can be used safely. For this purpose, D-dimer measurement and compression ultrasonography are complementary: the former is mainly used to exclude VTE in selected patients, while the latter is used to confirm the presence of an underlying DVT.

This review provides an appraisal of the features and use of D-dimer and compression ultrasonography in the context of suspected venous thromboembolism.

Zusammenfassung

Die Diagnostik der venösen Thromboembolie hat sich mit der Entwicklung standardisierter diagnostischer Algorithmen, die eine Beur- teilung der klinischen Wahrscheinlichkeit, einen D-Dimer-Test und die Anwendung nichtinvasiver bildgebender Verfahren wie die Kompressionssonografie oder die CT-Angiografie einschließen, deutlich verbessert. Die Implementierung dieser strategischen Ziele hat die Verbesserung des Ressourceneinsatzes und des Ergebnisses beim Patienten zum Ziel. Der vernünftige Einsatz dieser diagnostischen Methoden erfordert eine genaue Kenntnis der geeigneten klinischen Bedingungen, unter denen jeder Test und jede Strategie effizient ist und sicher angewendet werden kann. Hierbei sind D-Dimer-Test und Kompressionssonografie als komplementär anzusehen: Ersterer wird vor allem zum Ausschluss einer VTE bei ausgewählten Patienten eingesetzt, Letzterer zur Bestätigung einer vorliegenden TVT.

In dieser Übersicht werden Eigenschaften und der Einsatz des D-Dimer-Tests und der Kompressionssonografie bei Verdacht auf venöse Thromboembolie beurteilt.

Keywords

D-dimer - ultrasonography - clinical probability - deep vein thrombosis

Schlüsselwörter

D-Dimer - Dopplersonografie - klinische Wahrscheinlichkeit - tiefe Venenthrombose

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