Axillary and subclavian venous thrombosis: follow-up evaluation with color Doppler flow US and venography.

Abstract

Real-time ultrasonography (US) and color Doppler flow mapping were used to determine prospectively whether venous thrombosis in the upper extremity could be imaged as accurately as with conventional contrast venography. Thirteen patients were imaged. The diagnosis of spontaneous (or "effort") thrombosis was made clinically and confirmed intially at venography (n = 11) or at technetium-99m dynamic scintigraphy (n = 2). After therapy, follow-up imaging with color Doppler flow US and venography was performed in all 13 patients for correlation. Absence of flow signals was noted in five patients with complete occlusion of the subclavian vein, and decreased flow signal was seen in two patients with partial obstruction of the subclavian vein. In five patients, findings returned to normal at color Doppler flow US and venography, and patent collateral veins were seen in one patient. The authors conclude that color Doppler flow US is useful in evaluating venous thrombosis in the upper extremity and might be preferable to venography for follow-up because the discomfort of injection and risk of contrast material-induced phlebitis are eliminated.