Diagnostic value of CT for deep vein thrombosis: results of a systematic review and meta-analysis

Thomas, S.M.; Goodacre, S.W.; Sampson, F.C.; van Beek, E.J.R.

doi:10.1016/j.crad.2007.09.010

« Previous Next »Clinical Radiology
Volume 63, Issue 3 , Pages 299-304, March 2008

Diagnostic value of CT for deep vein thrombosis: results of a systematic review and meta-analysis☆

S.M. Thomas
- Academic Vascular Unit, University of Sheffield, Community Sciences Centre, Northern General Hospital, Sheffield, UK
- Guarantor and correspondent: S.M. Thomas, Academic Vascular Unit, University of Sheffield, Community Sciences Centre, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Tel.: +44 (0)114 2714662; fax: +44 (0)114 2715915.
S.W. Goodacre
- Health Services Research Section, ScHARR, University of Sheffield, Sheffield, UK
F.C. Sampson
- Health Services Research Section, ScHARR, University of Sheffield, Sheffield, UK
E.J.R. van Beek
- Department of Academic Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
- Present address: Carver College of Medicine, University of Iowa Hospitals and Clinics,Department of Radiology, 3895 JPP, 200 Hawkins Drive, Iowa City, IA 52242-1077, USA.

Received 26 July 2007; accepted 24 September 2007.

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.