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Professor Dr. Kent Yucel MD, prominent MRI and CT expert and interventional radiologist with particular focus on heart disease diagnosis by MRI and CT Angiography, and treatments by minimally invasive interventional radiology methods, and Dr. Anton Titov MD / Exclusive interview
- Embolism or pulmonary artery can be fatal in up to 30% of cases. - Yes. And the most frequent cause is Deep Venous Thrombosis - DVT, the presence of blood clots in the deep veins of legs. You have published a number of important papers on imaging studies of peripheral blood vessels, including papers on multimodality assessment of leg veins. What is the approach a person with suspected or known problem with blood clots in leg veins, DVT [Deep Vein Thrombosis], can take to evaluate the situation and make sure that the event of pulmonary artery embolism is prevented? Patient with DVT is going to present in one of two ways. They can either present with leg symptoms due to clots in the legs, or they can present with lung symptoms - shortness of breath or coughing up blood, due to clot from the legs having already gone to the lungs. That's a different approach depending on how they present. People who present with leg vein symptoms, get ultrasound right now of the legs. Ultrasound is really the test of choice for leg veins. CT or MRI can be helpful but they are not as good as ultrasound at finding small clots that can lead to bigger problems later on. So ultrasound of legs is really the way to go. The only exception to that is people who may have pelvic disease or pelvic surgery, who may develop blood clots not in the legs but in their pelvic veins because ultrasound can't see the pelvic veins well. Sometimes ultrasound can show a hint that maybe something is wrong with the pelvis, or the patient may have a known condition in the pelvis, like a tumor or surgery that will lead the doctor to worry about that. In those patients CT or MRI is preferable to ultrasound. Those are very special groups. For leg clots, ultrasound is the way to go. For diagnosing clots that have gone to the lungs and causing lung symptoms, CT is the diagnostic test of choice, for a variety of reasons. MRI of the pulmonary arteries is not sufficiently good to evaluate for pulmonary embolism. And ultrasound cannot see through the lung air. So CT is the test of choice for pulmonary embolism evaluation. An example of pelvic disease is - if someone had surgery for uterine cancer or other tumors in the abdominal or pelvic area - this would be the types of diseases that could give rise potentially to clots in the pelvic vascular system. Exactly. And ultrasound of the legs can often show indirect signs that there is a blockage in the pelvic veins. But it may not be able to help what's causing the problem. So just blood from surgery or a tumor or a clot in pelvic veins can cause blockages and ultrasound cannot tell them apart, but that's where CT and MRI are most helpful.
Deep Vein Thrombosis: How Blood Clots in Legs are Diagnosed? (12) top doctors mexico | |
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| Science & Technology | Upload TimePublished on 10 Jul 2018 |
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