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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Clinical Value of Deep Vein Thrombosis Density on Lower-Extremity CT Venography: Prediction of Pulmonary Thromboembolism

Author(s): Jae Hyeop Jung, Jin Kyem Kim, Taeho Kim and Dong Kyu Kim*

Volume 20, 2024

Published on: 24 May, 2023

Article ID: e050423215455 Pages: 7

DOI: 10.2174/1573405620666230405104312

open_access

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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.

Keywords: Deep vein thrombosis, Hounsfield unit, Density, Lower extremity, Computed tomography, Pulmonary thromboembolism.

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