Phleborheography: A Correlative Study with Venography

The Vascular Laboratory of Henry Ford Hospital has used the Cranley-Grass Phleborheograph (PRG) as the primary noninvasive method to determine the presence or absence of deep venous thrombosis (DVT) in the lower limbs since December 1977. In order to determine its proper role and clinical reliability, we compared the diagnostic accuracy of phleborheography with contrast venography. From December 1977 through December 1978, 483 cases (963 limbs) were successfully examined by PRG. Ofthese, 111 cases (216 limbs) also had contrast venography. The PRG was confirmed as normal in 151 out of 157 (6 false negatives). There were 53 abnormal PRCs, with 35 confirmed by venography and 18 false positives. Six PRCs were considered equivocal. Sensitivity on a per limb basis was .85. The overall specificity was .86, and when equivocal examinations were excluded, it was .89. Phleborheography is safe, reliable, widely applicable, and well-tolerated. However, skilled technicians and careful interpretation are essential to its success