ULTRASOUND CRITERIA FOR EMBOLOGENICITY OF VENOUS THROMBOSIS

L.E. Shulgina, A.A. Karpenko, V.P. Kulikov, Yu.G. Subbotin
Chair of Pathophysiology, functional and ultrasound Diagnosis, Altai State Medical University, Department of Functional Diagnosis, Department of Vascular Surgery, Regional Clinical Hospital,
Barnaul, Russia

Altogether 136 patients aged 17 to 79 years with a diagnosis of acute and subacute thrombosis of lower limb deep veins were examined by duplex scanning in order to derive the ultrasound criteria for embologenicity of inferior vena cava thrombosis. The authors evaluated thrombosis standing (from the emergence of the first clinical signs to its diagnosis), the length and site of the floating portion, the area of the transverse section of the thrombus, the character of the external contour, and the degree of thrombotic mass mobility. It has been established that: along with the generally accepted criteria for floating thrombi there is a number of the echographic characteristics which exert a significant effect on the probability of embolic complications; the degree of thrombotic mass mobility has a material effect on the incidence of thromboembolic complications and may be classified as insignificant, moderate and pronounced while embolic complications are largely present when the mobility of thrombotic masses is moderate or pronounced; the incidence of thromboembolic complications is significantly higher in the presence of a floating thrombus having uneven hypo- and isoechogenic contour and heterogeneous structure. The even hyperechogenic contour and homogeneous structure are common to the "organized thrombi", with the threat of their detachment being appreciably less. The differences have been demonstrated in the times of the fixation of the "non-organized" floating thrombi (heterogeneous, marked by the uneven external contour with the predominance of hypo- and isoechogenic areas) as compared to the cases when the thrombi were more "organized".

KEY WORDS: ultrasound angioscanning, deep venous thrombosis, floating thrombus, pulmonary thromboembolism.

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