Clinical Value of Deep Vein Thrombosis Density on Lower-Extremity CT Venography: Prediction of Pulmonary Thromboembolism

Abstract

Aim: Diagnosis of pulmonary thromboembolism (PTE) can be delayed if the signs and symptoms of patients are nonspecific. Introduction: To assess the clinical value of deep vein thrombosis (DVT) density on computed tomography (CT) venography for predicting PTE. Methods: From 2016 to 2021, patients with DVT diagnosed on lower-extremity CT venography were included. Of these patients, those without PTE were classified into &apos;DVT-only group&apos; and those with PTE were classified into the &apos;DVT with PTE group&apos;. The DVT Hounsfield unit (HU) density was measured by drawing free-hand region-of-interests within the thrombus at the most proximal filling defect level. The risk factors associated with PTE were identified by using multivariate logistic regression analysis. A receiver operating characteristic (ROC) analysis was used to evaluate the value of DVT density for predicting the risk of PTE. Results and Discussion: This study included 177 patients with a mean age of 41.7 10.3 years (DVT-only group: 105 patients; DVT with PTE group: 72 patients). DVT density was significantly higher in DVT with the PTE group than DVT-only group (66.8HU +/- 8.7 vs. 57.9HU +/- 11.1, p < 0.001). The ROC analysis revealed that the area under the curve (AUC), sensitivity, and specificity for predicting the risk of PTE were 0.737, 72.2%, and 66.7%, respectively, at a DVT density cutoff of 63.0 HU. On univariate and multivariate analysis, DVT density was the only significant risk factor associated with PTE. Conclusion: Higher DVT density was a significant risk factor for PTE. In addition, DVT density could be a predictive factor for PTE.