Ultrasound elastography predicts anticoagulation in lower extremity deep vein thrombosis

Article type: Research Article

Authors: Zhang, Ao-Yi^{a; #} | Dong, Ya-Xin^{a; #} | Tan, Yan-Di^b | Dian-Shen, ^a | Heng-Sun, ^a | Nie, Shu-Ting^a | Shao, Yuan-Yuan^a | Feng-Xian, ^a | Hu, Wen-Shu^a | Li, Xin-YI^a | Tao-Xu, ^a | Li, An-Ni^a | Liang-Xu, ^a | Chang-Zhou, ^{a; *}

Affiliations: [a] Department of Ultrasound, the First Clinical Medical Science College of China Three Gorges University and Yichang Central People’s Hospital, Yi chang, Hubei, China | [b] Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

Correspondence: [*] Corresponding author: Dr. Chang Zhou, Department of Ultrasound, the First Clinical Medical Science College of China Three Gorges University and Yichang Central People’s Hospital, Yichang, Hubei, China. Tel.: +86 15871618659; Fax: +86(717)6482302; E-mail: [email protected].

Note: [#] Aoyi Zhang and Yaxin Dong are the first coauthors and contributed equally to this work.

Abstract: OBJECTIVE: To investigate predictors of anticoagulation efficacy in deep venous thrombosis (DVT) by ultrasound elastography (UE). METHODS: The basic clinical, laboratory and ultrasound treatment data of fifty-eight patients with DVT were collected and analyzed. Then the results of ultrasound after 3-month anticoagulation treatment were compared among different groups. Multiple logistic regression analysis was used to identify independent risk factors that affected anticoagulation efficacy. The predictive efficacy of each independent risk factor was accessed by drawing operating characteristic (ROC) curves. RESULTS: According to the regression analysis, the elastic modulus (OR = 0.631, P = 0.001) and strain rate ratio (OR = 0.332, P = 0.006) were identified as independent risk factors for the effectiveness of anticoagulation therapy in patients with DVT. According to the ROC curves, elastic modulus and strain rate ratio could predict effective anticoagulation therapy for DVT, and the optimal threshold values were 22.10 kPa and 1.80 respectively. The corresponding AUC values were 0.879 and 0.854, with a sensitivity of 71.4% and 59.5%, a specificity of 93.7%, and a Youden index of 65.1% and 62.7%, respectively. CONCLUSIONS: The elastic modulus (≤22.10 kPa) or strain rate ratio (≤1.80) of the thrombus were independent predictors for the effectiveness of anticoagulation therapy.

Keywords: Elastography, deep vein thrombosis, anticoagulation

DOI: 10.3233/CH-232031

Journal: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 171-185, 2024