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Dronkers, C.E.A. (2019)

Deep vein thrombosis : diagnostic and prognostic challenges

Doctoral Thesis
This thesis about deep vein thrombosis consists of two parts. The studies described in the first part of this thesis aimed to improve the diagnostic management of deep vein thrombosis (DVT) in general, and in diagnostic challenging circumstances specifically. First, a new diagnostic safety threshold for all future diagnostic studies in deep vein thrombosis was established, adjusted to the disease prevalence in the study population. Thereafter a new simpler clinical decision rule, as first step in the diagnostic management of DVT was designed, selecting 4 items of the Wells rule. In the following chapter’s, studies using the MRI technique: Magnetic Resonance Direct Thrombus Imaging (MRDTI) were described. This is a non-contrast enhanced MRI technique by which a thrombus can be visualized directly. This technique was applied to diagnose DVT in challenging circumstances: ipsilateral recurrent DVT, DVT in pregnant woman and upper extremity DVT. The second part of this thesis...Show moreThis thesis about deep vein thrombosis consists of two parts. The studies described in the first part of this thesis aimed to improve the diagnostic management of deep vein thrombosis (DVT) in general, and in diagnostic challenging circumstances specifically. First, a new diagnostic safety threshold for all future diagnostic studies in deep vein thrombosis was established, adjusted to the disease prevalence in the study population. Thereafter a new simpler clinical decision rule, as first step in the diagnostic management of DVT was designed, selecting 4 items of the Wells rule. In the following chapter’s, studies using the MRI technique: Magnetic Resonance Direct Thrombus Imaging (MRDTI) were described. This is a non-contrast enhanced MRI technique by which a thrombus can be visualized directly. This technique was applied to diagnose DVT in challenging circumstances: ipsilateral recurrent DVT, DVT in pregnant woman and upper extremity DVT. The second part of this thesis describes studies that aimed to improve the prognosis of DVT by evaluation of the persistence to prescribed therapy and predictors of the development of post thrombotic syndrome (PTS). Show less
Deep Vein Thrombosis
Diagnosis
Magnetic Resonance Imaging
Post-Thrombotic syndrome
All authors
Dronkers, C.E.A.
Supervisor
Huisman, M.V.
Co-supervisor
Klok, F.A.
Committee
Eikenboom, H.C.J.; Kroft, L.J.M.; Kamphuizen, P.W.; Westerlund, E.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2019-01-08
ISBN (print)
9789463611954