Title:Clinical Value of Deep Vein Thrombosis Density on Lower-Extremity CT
Venography: Prediction of Pulmonary Thromboembolism
Volume: 20
Author(s): Jae Hyeop Jung, Jin Kyem Kim, Taeho Kim and Dong Kyu Kim*
Affiliation:
- Department of Radiology, the Armed Forces Capital Hospital, Seongnamm 13574, Korea
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-Ro,
Seodaemun-Gu, Seoul 03722, Korea
Keywords:
Deep vein thrombosis, Hounsfield unit, Density, Lower extremity, Computed tomography, Pulmonary thromboembolism.
Abstract:
Aim:
Diagnosis of pulmonary thromboembolism (PTE) can be delayed if the signs and symptoms of patients are nonspecific.
Introduction:
To assess the clinical value of deep vein thrombosis (DVT) density on computed tomography (CT) venography for predicting PTE.
Methods:
From 2016 to 2021, patients with DVT diagnosed on lower-extremity CT venography were included. Of these patients, those without PTE were
classified into ‘DVT-only group’ and those with PTE were classified into the ‘DVT with PTE group’. The DVT Hounsfield unit (HU) density was
measured by drawing free-hand region-of-interests within the thrombus at the most proximal filling defect level. The risk factors associated with
PTE were identified by using multivariate logistic regression analysis. A receiver operating characteristic (ROC) analysis was used to evaluate the
value of DVT density for predicting the risk of PTE.
Results and Discussion:
This study included 177 patients with a mean age of 41.7 ± 10.3 years (DVT-only group: 105 patients; DVT with PTE group: 72 patients). DVT
density was significantly higher in DVT with the PTE group than DVT-only group (66.8HU ± 8.7 vs. 57.9HU ± 11.1, p < 0.001). The ROC
analysis revealed that the area under the curve (AUC), sensitivity, and specificity for predicting the risk of PTE were 0.737, 72.2%, and 66.7%,
respectively, at a DVT density cutoff of 63.0 HU. On univariate and multivariate analysis, DVT density was the only significant risk factor
associated with PTE.
Conclusion:
Higher DVT density was a significant risk factor for PTE. In addition, DVT density could be a predictive factor for PTE.
