Application value of real-time shear wave elastography in the diagnosis and efficacy evaluation of venous thrombosis

Abstract

BACKGROUND:

Deep vein thrombosis (DVT) of the lower limbs is a venous reflux disorder caused by abnormal coagulation of blood components, primarily characterised by swelling and pain in the lower limbs. Key risk factors include prolonged immobility due to bed rest, pregnancy, postpartum or postoperative states, traumas, malignant tumours and long-term contraceptive use.

OBJECTIVE:

To investigate the application of real-time shear wave elastography (SWE) in diagnosing lower-limb deep vein thrombosis (DVT).

METHODS:

A total of 91 patients with DVT were selected and divided into three groups: acute phase ( $n=$ 29), subacute phase ( $n=$ 30) and chronic phase ( $n=$ 32). The Young’s modulus of the patients was measured using real-time SWE. The diagnostic efficacy of Young’s modulus was evaluated by ROC curves. The hardness differences in Young’s modulus across different parts of the same thrombus (head, body and tail) were measured using SWE.

RESULTS:

Before treatment, significant differences were observed in Young’s modulus among patients with DVT ( $P<$ 0.001). Following anticoagulant therapy, catheter-directed thrombolysis and systemic thrombolysis, significant differences were noted in Young’s modulus among patients at the same stage but receiving different treatments (acute phase: $P=$ 0.003; subacute phase: $P=$ 0.014; chronic phase: $P=$ 0.004). Catheter-directed thrombolysis had greater efficacy than anticoagulant therapy. The area under the curve for SWE in staging patients was 0.917, with a sensitivity of 92.36% and specificity of 93.81%. Significant differences in Young’s modulus were found between the thrombus head and thrombus body and tail but not between the thrombus body and thrombus tail.

CONCLUSION:

Measurement of Young’s modulus using SWE can serve as an auxiliary means of evaluating staging, predicting pulmonary embolism and selecting treatment in patients with DVT.