Abstract：
Inconsistencies in the definition of clinically unsuspected venous thromboembolism (VTE) in pediatric patients recently led to the recommendation of standardizing this terminology. Clinically unsuspected VTE (cuVTE) is defined as the presence of VTE on diagnostic imaging performed for indications unrelated to VTE in a patient without symptoms or clinical history of VTE. The prevalence of cuVTE in pediatric cancer patients is unclear. Therefore, the main objective of our study was to determine the prevalence of cuVTE in pediatric cancer patients. All patients 0-18 years old, treated at the IWK in Halifax, Nova Scotia, from August 2005 through December 2019 with a known cancer diagnosis and at least one imaging study were eligible (n = 743). All radiology reports available for these patients were reviewed (n = 18,120). The VTE event was labeled a priori as cuVTE event for radiology reports that included descriptive texts indicating a diagnosis of thrombosis including thrombus, central venous catheter-related, thrombosed aneurysm, tumor thrombosis, non-occlusive thrombus, intraluminal filling defect, or small fragment clot for patients without documentation of clinical history and or signs of VTE. A total of 18,120 radiology reports were included in the review. The prevalence of cuVTE was 5.5% (41/743). Echocardiography and computed tomography had the highest rate of cuVTE detection, and the most common terminologies used to diagnose cuVTE were thrombus and non-occlusive thrombus. The diagnosis of cuVTE was not associated with age, sex, and type of cancer. Future efforts should focus on streamlining radiology reports to characterize thrombi. The clinical significance of these cuVTE findings and their application to management, post-thrombotic syndrome, and survival compared to cases with symptomatic VTE and patients without VTE should be further studied.
摘要：
最近，儿科患者临床上未怀疑的静脉血栓栓塞（VTE）定义的不一致导致建议标准化该术语。临床上未怀疑的VTE（cuVTE）定义为在没有VTE症状或临床病史的患者中对与VTE无关的适应症进行诊断成像时存在VTE。儿科癌症患者中cuVTE的患病率尚不清楚。因此,我们研究的主要目的是确定cuVTE在儿科癌症患者中的患病率.所有患者0-18岁，在哈利法克斯的IWK治疗,新斯科舍省,从2005年8月至2019年12月,已知癌症诊断和至少一项影像学研究符合资格(n=743).对这些患者的所有放射学报告进行了审查（n=18,120）。对于放射学报告，VTE事件被先验标记为cuVTE事件，包括描述性文本，表明血栓形成（包括血栓）的诊断。中心静脉导管相关,血栓形成的动脉瘤,肿瘤血栓形成,非闭塞性血栓,管腔内充盈缺损，或小碎片凝块，用于没有临床病史和/或VTE迹象的患者。审查中总共包括18,120份放射学报告。cuVTE的患病率为5.5%(41/743)。超声心动图和计算机断层扫描具有最高的cuVTE检出率，用于诊断cuVTE的最常见术语是血栓和非闭塞性血栓。cuVTE的诊断与年龄无关，性别,和癌症的类型。未来的工作应集中在简化放射学报告以表征血栓。这些cuVTE发现的临床意义及其在管理中的应用，血栓形成后综合征,与有症状的VTE和无VTE的患者相比，生存率应进一步研究。
