Which technique is considered the gold standard for diagnosing DVT?
A. Ultrasound imaging
B. Venography
C. MRI
D. Doppler flow study
Correct Answer: B. Venography
Proximal leg vein ultrasound, which when positive, indicates that the patient should be treated as having a DVT. If a patient scores 2 or above, either a proximal leg vein ultrasound scan should be done within 4 hours, and if the result is negative, a D-dimer test should be done. If imaging is not possible within 4 hours, a D-dimer test should be undertaken, and an interim 24-hour dose of a parenteral anticoagulant should be given. A proximal leg vein ultrasound scan should be carried out within 24 hours of being requested.
Option A: Complex duplex ultrasound is the imaging modality of choice. There is non-compressible venous segment; loss of phasic flow on Valsalva maneuver; absent color flow if completely occlusive; lack of flow augmentation with calf squeeze; and increased flow in superficial veins.
Option C: Vascular structures should always be interrogated during a routine assessment of the peripheries and pelvis. Incidental DVT has a prevalence of around 0.3% on routine outpatient knee MRI
Option D: Doppler flow is a type of ultrasound. It uses sound waves to measure the flow of blood through a blood vessel. The results are shown on a computer screen in lines called waveforms. It’s sometimes called Doppler velocimetry. A Doppler flow study may be used during pregnancy to check the health of the unborn baby (fetus).
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