彩色多普勒超声在下肢深静脉血栓形成诊断中的价值

目的探讨彩色多普勒血流成像(CDFI)对单侧不同范围下肢深静脉血栓形成(DVT)及其周围软组织改变的临床诊断价值。方法选取于我院行CDFI检查的80例下肢DVT患者作为观察对象,按血栓累及血管范围分为3级:I级(累及1根深静脉,46例)、II级(累及2根深静脉,26例)、III级(累及3根及以上深静脉,8例)。观察各级DVT的CDFI表现及邻近肌层、皮下组织的超声表现,并与同一健肢患者对比,测量患肢皮下组织增厚度、肌层增厚度、肌层回声改变及肌层组织形态改变等指标。结果 80例DVT患者声像图表现为管腔内可见不均匀低、中等回声,探头加压后不变瘪,Valsalva试验流速曲线无明显变化,CDFI不能探及血流信号,或仅有少许点线状血流。43例患肢皮下软组织稍增厚,回声稍增强,但血栓累及范围不同组之间皮下组织增厚度差异无统计学意义(P0.05)。63例患肢肌层厚度较健侧增厚,其中Ⅲ级组与Ⅰ级组差异有统计学意义(P0.05),且随血栓累及范围越广肌层厚度增加越明显。64例患肢肌层组织回声较健侧回声减低或增高,但回声变化强度与血栓累及范围差异无统计学意义(P0.05);70例患肢肌层组织形态发生改变,部分患肢肌间隙可见裂隙样或片状无回声,有的可探及迂曲扩张的血管,且随血栓累及范围越广(达Ⅲ级)征象越明显(P0.05)。结论 CDFI不但能直观地显示下肢静脉血栓,而且能清晰反映患肢肌层及皮下组织情况,具有较高的临床价值。

Value of Color Doppler Ultrasound in Diagnosis of deep Venous Thrombosis of Lower Extremity

Objective To investigate the effect of color Doppler flow imaging ( CDFI) of unilateral lower extremity deep venous thrombosis ( DVT) and its surrounding soft tissue change of clinical diagnostic value . Methods selected in our hospital underwent CDFI examination of 80 cases of lower extremity DVT patients as observation objects involved thrombus blood vessel is divided into 3 grades:Grade I ( involving 1 root deep vein,46 cases),grade II(involving 2 deep vein,26 cases),grade III(involving 3 and above deep vein,8 cases).Observations at all levels DVT color Doppler flow imaging (CDFI)and adjacent muscle,subcutaneous tissue ,and with a healthy limb patients Ratio measurements from limb subcutaneous tissue thickening ,muscle layer thickness , muscle layer echo changes and muscle layer tissue morphological changes such as index . Results 80 cases of DVT in patients with sonographic manifestations for the lumen showed heterogeneous low,medium echo,probe pressure constant deflated ,Valsalva test flow velocity curve had no obvious change , the CDFI inability to detect blood flow signal , or only a few linear flow in 43 cases of suffering from limb subcutaneous soft tissue slightly thickened , echo was slightly increased , but thrombosis involving the scope between different groups of subcutaneous tissue thickening of the difference of no statistical significance ( P>0.05)63 cases suffering from limb girdle muscular layer thickness than the healthy side thickening ,which III Group level and grade I group , the difference has statistical significance ( P <0.05 ) , and with thrombosis involving the range more widely muscle layer thickness increases more obvious 64 cases suffering from limb muscle tissue echogenicity compared with the healthy side echo decreased or increased , but changes of echo intensity and the extent of thrombosis were no statistical significance ( P >0.05 );70 cases of limb muscle tissue morphological changes , some of the risk of limb muscle gap visible crack like or flake no echo , some exploration and tortuous and dilated blood vessels and with thrombosis involving the scope wider ( reached grade III ) features more obvious ( P <0.05 ) .Conclusion CDFI can not only intuitively showed lower extremity DVT,but also to clear Clearly reflect the limb muscle layer and subcutaneous tissue ,it has important clinical value .