Echogenic Types of Venous Thrombi in the Common Femoral Vein by Ultrasonic B-Mode Imaging

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Abstract
In order to more precisely evaluate deep venous thrombosis (DVT), venous thrombi in the common femoral vein (CFV) were classified according to size of clots and their echogenicity by means of ultrasonic B-mode imaging, and the echogenic types were correlated with the clinical course and presentation of DVT in 106 lower extremities of 81 patients with DVT. They underwent venous Doppler study, venous outflow measurement, and ultrasonic B-mode imaging. Seven clots in the CFV were removed for histologic examination. Of 106 lower extremities 71 had clots in the CFV. These were classified into three types (A, B, C) and eight subtypes (A1, A2, B1, B2, B3, C1, C2, C3). Type A was thick and homogeneous (41 %), type B was thick and heterogeneous (35%), and type C was thin (24%). Types A (83%) and B (88%) were more frequently noted within one month from the onset than type C (12%) (p<0.01, p<0.001, respectively): 88 % of type C was identified after more than one month. Types A and B were correlated with the acute symptoms of DVT (pain, swelling, discoloration), but type C was correlated with the chronic symptoms (pigmentation, stasis ulcer). The echogenic classification of venous thrombi by ultrasonic B-mode imaging is useful for precise evaluation of DVT.