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What scenarios do you utilize CT venography in the workup of suspected DVT?

How does this inform the evaluation of a symptomatic patient with negative DVT US?
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In a symptomatic patient with a negative lower-extremity DVT ultrasounds, do you obtain CT venography to evaluate for proximal/pelvic venous thrombosis?

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2 Answers
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Mednet MemberInvited Expert
Hematology · Mayo Clinic
Answered on

There are likely a limited number of scenarios in which a CT venogram should be ordered. My own approach is as follows:

  1. Bilateral deep venous thrombosis: to exclude IVC obstruction. Anecdotally, in the younger patients, we have made a diagnosis of IVC atresia.
  2. Suspected May-Thurner syndrome: typica...

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Mednet Member
Mednet MemberInvited Expert
Hematology · Penn Medicine, University of Pennsylvania Health System
Answered on

I reserve the CT venogram for patients with a high suspicion of DVT.

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