Which description best matches chronic DVT findings on ultrasound?

• A. Hypoechoic thrombus with dilated vein and no collaterals
• B. Acute thrombus with dilated, hypoechoic
• C. No thrombus
• D. Hyperechoic thrombus, contracted vein, collaterals present, thrombus may appear more solid

Answer: (D)

Chronic DVT on ultrasound shows a thrombus that has become organized and scarred, so it appears brighter (hyperechoic) and more solid rather than soft. The vein itself is often contracted from fibrotic remodeling, not dilated, and collateral vessels develop around the blocked segment to reroute blood flow. These features—echogenic, firmer clot plus a contracted vein and visible collaterals—are typical of a long-standing occlusion.

In contrast, acute DVT tends to be hypoechoic or isoechoic within a dilated vein and may lack well-formed collaterals yet, while no thrombus would show as a patent vein.