Purpose or Case Report: Venous thromboembolism (VTE) is a multifactorial disease and a significant source of morbidity. Though the incidence of VTE, composed of deep venous thrombosis (DVT) and pulmonary emobolism (PE), is more common in adults, an increasing number of children are being diagnosed. Children who are critically ill are at greatest risk of developing VTE.

Duplex sonography is a critical front line tool in the detection and evaluation of venous thrombosis. Serial surveillance examinations allow real-time assessment of thrombosis including propagation and progression.

Recognizing the presentation and sonographic appearance of venous thrombosis assists the clinician in timely therapeutic decision-making and clinical management.

The goals of this exhibit are:

1. Describe the technical approach of performing duplex vascular ultrasound, including tips and technology that assist in optimizing studies.
2. Discuss the incidence, risk factors, and clinical characteristics of pediatric VTE.
3. Depict the sonographic appearance of thrombosis with emphasis on correlation to other modalities.
4. Discuss prognosis and long-term outcomes of VTE in children.
5. Describe future techniques and applications.
Methods & Materials: Duplex vascular ultrasound studies at our institute were reviewed retrospectively with selected representative cases chosen to illustrate technical aspects and clinical indications for this procedure. Correlation was made with follow up radiology studies, clinical and/or surgical outcomes.

Causes of venous thrombosis, including those due to trauma, infection, inflammation, and malignancy, will be described.
Results: An increasing number of pediatric patients treated at tertiary care centers are being diagnosed with VTE. Central venous catheters (CVC) are the most common cause of VTE in children. Typical findings in normal and abnormal pediatric venous duplex exams will be illustrated. Emphasis on technique and methodology for serial examination is described. Characterization of venous waveforms will be discussed.
Conclusions: Through this exhibit, participants will learn about the diagnostic evaluation of pediatric venous thrombosis, including sonographic appearance and characteristics of spectral waveforms. Correlation will be made to other modalities in cases of VTE.