We perform a whole-leg ultrasound of the symptomatic lower extremity in all patients with clinical suspicion of acute DVT in our institution as a combination of color-coded duplex ultrasound, compression ultrasound, and B-mode ultrasound from the groin to the lower leg by using a high-end ultrasound device (Aplio XG, Toshiba) and a linear transducer (PLT 604 AT, 6 MHz, Toshiba). In the case of suspicion of deep vein thrombosis of the iliac veins, the iliac veins are additionally examined using a convex transducer (PVT 375 BT, 3.5 MHz, Toshiba). The images are stored in the digital image archive (PACS, Agfa Impax 6.5.3). The ultrasound evaluation is performed or supervised by board-certified radiologists with subspecialisation in vascular and interventional radiology. Our protocol includes.
compression ultrasound performed at 2 cm intervals from the common femoral vein to the ankle including the peroneal and posterior tibial veins in the calf,
colour-coded duplex evaluation from the common femoral vein to the ankle,
spectral doppler evaluation of the wave form in the common femoral vein (in case of abnormal waveform suggesting obstruction above the inguinal ligament, additional colour-coded duplex evaluation of the iliac veins is performed) and
targeted ultrasound of symptomatic areas if symptoms are not explained by findings on standard thigh-to-ankle examination.