Doppler ultrasound venous mapping of the lower limbs

Aldo Innocente Galeandro¹, Giovanni Quistelli², Pietro Scicchitano², Michele Gesualdo², Annapaola Zito², Paola Caputo², Rosa Carbonara², Giuseppe Galgano³, Francesco Ciciarello⁴, Sandro Mandolesi⁴, Claude Franceschi⁵, Marco Matteo Ciccone^2
1Centro Diagnostica Globale and ASL-TA, Taranto, Italy; ²Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy; ³Cardiovascular Diseases Section, Ente Ecclesiastico Ospedale Generale Regionale F Miulli, Acquaviva delle Fonti, Bari, Italy; ⁴Cardiology Department, Policlinico Umberto I, Sapienza University of Rome, Italy; ⁵Vascular Laboratories of Hospitals Saint Joseph and Pitié-Salpétrière, Paris, France

Background: The study aim was to test the accuracy (intra and interobserver variability), sensitivity, and specificity of a simplified noninvasive ultrasound methodology for mapping superficial and deep veins of the lower limbs.
Methods: 62 consecutive patients, aged 62 ± 11 years, were enrolled. All underwent US-examinations, performed by two different investigators, of both legs, four anatomical parts, and 17 veins, to assess the interobserver variability of evaluation of superficial and deep veins of the lower limbs.
Results: Overall the agreement between the second versus the first operator was very high in detecting reflux (sensitivity 97.9, specificity 99.7, accuracy 99.5; P = 0.80 at McNemar test). The higher CEAP classification stages were significantly associated with reflux (odds ratio: 1.778, 95% confidence interval: 1.552–2.038; P < 0.001) as well as with thrombosis (odds ratio: 2.765, 95% confidence interval: 1.741–4.389; P < 0.001). Thus, our findings show a strict association between the symptoms of venous disorders and ultrasound evaluation results for thrombosis or reflux.
Conclusion: This study demonstrated that our venous mapping protocol is a reliable method showing a very low interobserver variability, which makes it accurate and reproducible for the assessment of the morphofunctional status of the lower limb veins.

Keywords: venous mapping, new methodology, sensitivity, specificity, accuracy