S M Thomas1, S W Goodacre, F C Sampson, E J R van Beek. 1. Academic Vascular Unit, University of Sheffield, Community Sciences Centre, Northern General Hospital, Sheffield, UK. s.m.thomas@sheffield.ac.uk
Abstract
AIM: To estimate the sensitivity and specificity of computed tomography (CT) for the diagnosis of deep vein thrombosis (DVT) in patients with suspected DVT and pulmonary embolus (PE). MATERIALS AND METHODS: A search of the medical literature and citation lists was undertaken, and selected studies comparing CT to a reference standard in patients with suspected DVT or PE were retrieved. Data were analysed by random effects meta-analysis. RESULTS: Thirteen articles were included in the meta-analysis. Most compared CT to ultrasound in patients with clinically suspected PE. The sensitivity ranged from 71-100%, while specificity ranged from 93-100%. The pooled estimate of sensitivity was 95.9% (95% CI 93 to 97.8%) and the pooled estimate of specificity was 95.2% (93.6 to 96.5%). However, pooled estimates should be interpreted with caution as these were subject to significant heterogeneity (p=0.025 and p<0.001, respectively). Most studies only appeared to report proximal DVT. Too few data were available to estimate sensitivity for distal DVT. CONCLUSIONS: CT has a similar sensitivity and specificity to ultrasound in patients with suspected PE where investigation of suspected DVT is required. There is insufficient research to determine the diagnostic accuracy of CT in patients with suspected DVT alone.
AIM: To estimate the sensitivity and specificity of computed tomography (CT) for the diagnosis of deep vein thrombosis (DVT) in patients with suspected DVT and pulmonary embolus (PE). MATERIALS AND METHODS: A search of the medical literature and citation lists was undertaken, and selected studies comparing CT to a reference standard in patients with suspected DVT or PE were retrieved. Data were analysed by random effects meta-analysis. RESULTS: Thirteen articles were included in the meta-analysis. Most compared CT to ultrasound in patients with clinically suspected PE. The sensitivity ranged from 71-100%, while specificity ranged from 93-100%. The pooled estimate of sensitivity was 95.9% (95% CI 93 to 97.8%) and the pooled estimate of specificity was 95.2% (93.6 to 96.5%). However, pooled estimates should be interpreted with caution as these were subject to significant heterogeneity (p=0.025 and p<0.001, respectively). Most studies only appeared to report proximal DVT. Too few data were available to estimate sensitivity for distal DVT. CONCLUSIONS: CT has a similar sensitivity and specificity to ultrasound in patients with suspected PE where investigation of suspected DVT is required. There is insufficient research to determine the diagnostic accuracy of CT in patients with suspected DVT alone.
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