DSA静脉造影诊断小腿深静脉血栓的价值

目的评价数字血管减影造影（DSA）下肢静脉顺行造影对小腿深静脉血栓的敏感度和特异度。方法30例临床拟诊下肢深静脉血栓形成的病人,同时行超声检查和静脉造影检查、应用DSA行下肢静脉造影检查,旋转大C臂多角度、多方位观察研究下肢深静脉血栓。结果大腿深静脉血栓超声与血管造影检查结果大致相同;小腿深静脉血栓超声与血管造影检出率有显著性差异,p〈0．05。结论应用DSA行下肢静脉顺行造影诊断小腿深静脉血栓敏感性、特异性较高。     

2D-CDFI诊断下肢深静脉血栓20例分析

下肢深静脉血栓是血管系统的常见病。二维彩色多谱勒超声（2D—CDFI）可观察血管解剖及血流情况,对深静脉主干血栓具有敏感性和特异性。本文对20例经静脉造影诊断为下肢深静脉血栓（DVT）的超声图像进行分析,探讨超声对该病的诊断价值。     

人工关节置换术后下肢深静脉血栓形成的彩色多普勒超声诊断

目的探讨彩色多普勒超声在人工关节置换术后下肢深静脉血栓诊断中的价值。方法对人工关节置换术后65例下肢静脉同期行彩色多普勒超声检查和X线静脉造影,分析彩色多普勒超声诊断下肢深静脉血栓(DVT)的准确性。结果与X线静脉造影对比,彩色多普勒超声诊断人工关节置换术后深静脉血栓形成的灵敏度85%、特异度100%、准确度95.3%;在小腿肌间静脉血栓的诊断上优于静脉造影(P<0.05);伴有下肢深静脉瓣功能不全的静脉容易发生深静脉血栓(P<0.05)。结论彩色多普勒超声是诊断人工关节术后下肢深静脉血栓形成的可靠方法。     

彩色多普勒超声诊断下肢深静脉血栓的临床价值分析

选取我院2011年10月~2014年12月收治的52例疑似下肢深静脉血栓患者,对52例疑似下肢深静脉血栓的患者均实施彩色多普勒超声诊断以及下肢深静脉造影检查,观察比较两种检查方式的结果。经下肢深静脉造影检查确诊为下肢深静脉血栓患者为40例。彩色多普勒超声诊断特异度为66.67%,敏感度为80.00%,误诊4例,误诊率为33.33%,漏诊8例,漏诊率为20.00%,诊断准确性为76.92%;有31例患者为左下肢静脉病变,有17例患者为右下肢静脉病变,有4例患者为双下肢静脉病变。彩色多普勒超声诊断下肢深静脉血栓对早期诊断、治疗具有重要的临床价值,值得推广。     

全膝关节置换后下肢静脉血栓：完全加压超声联合彩色血流多普勒显像评估

目的:分析完全加压超声联合彩色血流多普勒显像对全膝关节置换后下肢深静脉血栓的诊断价值。方法:随机抽取2006-03/09择期行全膝关节初次置换患者42例59膝,其中左膝14例,右膝11例,双膝17例。均选用美国Depuy公司含庆大霉素骨水泥固定假体。置换后(13±2)d均由专人做双下肢完全加压超声联合彩色血流多普勒显像检查和静脉造影检查。结果:完全加压超声联合彩色血流多普勒显像检查共发现急性下肢深静脉血栓者12例,有症状者3例,其中单膝1例,双膝2例。血栓部位均在远端,其中左下肢者5例,右下肢者3例,双下肢者4例。静脉造影检查共发现急性下肢深静脉血栓者7例,有症状者3例,其中单膝1例,双膝2例;血栓部位均在远端,其中血栓部位在左下肢者3例,右下肢者2例,双下肢者2例。与静脉造影检查相比,完全加压超声联合彩色血流多普勒显像检查在下肢深静脉血栓的诊断方面,其精密度达到0.714,特异度为0.80。结论:采用完全加压超声联合彩色血流多普勒显像检查可以形成特定的声像资料,与静脉造影相比具有较高的特异性和灵敏度。     

彩色多普勒超声联合直接法多层螺旋CT静脉造影诊断深静脉血栓的临床研究

目的探讨彩色多普勒超声联合直接法多层螺旋CT静脉造影(MSCTV)诊断深静脉血栓的临床应用价值。方法收集13例经临床证实的深静脉血栓患者的影像学资料,分析其直接法MSCTV及彩色多普勒超声影像特征。结果上肢深静脉血栓2例,下肢深静脉血栓11例。直接法MSCTV深静脉血栓表现为充盈缺损,静脉腔变细、闭塞,侧支血管迂曲、扩张;彩色多普勒超声深静脉血栓表现为静脉腔内的实性回声,周围无血流信号或仅有细小血流信号。结论深静脉血栓具有典型的MSCTV及彩色多普勒超声征象,彩色多普勒超声联合直接法MSCTV能够及时、准确地诊断深静脉血栓。     

下肢深静脉血栓形成的危险因素及多普勒超声诊断价值分析

目的:探讨下肢深静脉血栓形成的危险因素及多普勒超声诊断价值。方法:选取2014年5月~2017年5月我院接诊的86例疑似下肢深静脉血栓患者为研究对象,均行多普勒超声及数字减影血管造影检查,以数字减影血管造影为金标准,探讨多普勒超声检查在下肢深静脉血栓诊断中的应用价值,分析下肢深静脉血栓形成的危险因素。结果:普勒超声诊断诊断准确率为96.5%;髂静脉、股静脉、腘静脉、股静脉至筋脉累及、胫前与胫后静脉诊断灵敏度分别为75.0%、96.9%、90.0%、100.0%、100.0%;下肢深静脉血栓形成患者的脑血管病史、静脉血栓史及发热等均显著高于非下肢深静脉血栓形成患者(P<0.05)。结论:患者脑血管病史、静脉血栓史及发热是下肢深静脉血栓形成的高危因素。多普勒超声诊断下肢深静脉血栓形成操作简单、准确率高,值得临床推广应用。     

彩色多普勒超声诊断下肢深静脉血栓的临床效果评价

目的评价彩色多普勒超声诊断下肢深静脉血栓的临床效果。方法回顾性分析我院2016年9月至2018年10月收治的76例可疑下肢深静脉血栓患者彩色多普勒超声及深静脉造影检查的相关资料,以深静脉造影检查结果为对照,计算彩色多普勒超声诊断下肢深静脉血栓的准确度及灵敏度,并比较彩色多普勒超声与深静脉造影对小腿深静脉及大腿深静脉的检查情况。结果彩色多普勒超声检查静脉数160条,深静脉造影检查静脉数245条;两种方法对小腿深静脉的检查差异有统计学意义(P 0.05),对大腿深静脉的检查差异无统计学意义(P0.05)。以深静脉造影结果为参照,彩色多普勒超声检查大腿深静脉的准确度及灵敏度较高,检查小腿深静脉的准确度及灵敏度较低。结论下肢深静脉血栓的诊断中,经彩色多普勒超声对大腿深静脉的检查与深静脉造影并无差异,而对于小腿深静脉的检查不如深静脉造影。     

彩色多普勒超声诊断下肢深静脉血栓形成的价值探讨

目的:探讨彩色多普勒超声诊断下肢深静脉血栓形成的价值。方法:选取2018年1月-2019年12月我院接收的疑似下肢静脉血栓形成的80例患者为本研究对象。所有患者首先进行彩色多普勒超声检查之后进行静脉造影检测,将静脉造影作为金标准,比较两种检测的敏感性及特异性。结果:在疑似的80例患者中静脉造影共检出下肢静脉血栓80条,彩色多普勒超声检出76条;彩色多普勒超声检测的敏感性95.9%(71/74),特异性为83.3%(5/6)诊断符合率为92.5%(74/80),两种检测方式进行计数检验,X~2=1.031,P0.05,因此两种检测的准确率无显著差异。结论:对下肢静脉血栓形成的患者采用彩色多普勒超声检查,具有无创性及可重复性,其敏感性及特异性相对较高,从而能够为临床诊断及治疗措施提供有效指导,利于临床应用及推广。     

超声造影在血管疾病中的应用

目的 探讨超声造影在门静脉、颈动脉及下肢深静脉疾病中的应用价值.方法 应用超声造影观察门静脉,颈动脉及下肢深静脉疾病患者63例,其中门静脉栓子20例,下肢深静脉血栓15例,颈动脉狭窄28例,分别观察造影剂增强及血管充盈情况,并与增强CT及DSA对照.结果 15例门静脉瘤栓造影后均表现为不同程度增强,5例血栓无增强,表现为充盈缺损,颈动脉超声造影可清晰显示动脉内-中膜厚度,发现21个造影前未发现的斑块,勾勒出动脉斑块大小及形态.与DSA对照,应用CDFI、超声造影诊断动脉粥样硬化所致颈部动脉闭塞的敏感性分别为55.6%、55.6%,特异性分别为84.2%、94.7%,准确率分别为75.0%、82.0%.普通超声检查下肢下肢DVT的发现率为47%,超声造影后下肢下肢DVT的发现率为87%.患侧股总静脉造影剂出现时间及达峰值时间分别为(56.76±11.24)8、(61.43±7.12)S,健侧造影剂出现达峰值时间为(42.46±7.28)S、(51.57±5.79)s,双侧比较差异有统计学意义(P<0.05);患侧低回声带宽度为(0.31±0.08)cm,健侧为(O.09±0.03)cm,差异有统计学意义.结论 超声造影有助于门静脉栓子良恶性的鉴别诊断,提高了颈动脉斑块及静脉栓子的显示率,有助于动脉狭窄程度判断以及静脉血栓形成的诊断.     

Preoperative imaging of lower extremity varicose veins: color coded duplex sonography or venography.

We prospectively examined 137 limbs in 112 consecutive patients with clinical evidence of severe varicosis by color coded duplex sonography and ascending venography (including varicography in 48 limbs) to evaluate the diagnostic capabilities of color coded duplex sonography in the assessment of venous anatomy, variant varicosis, postthrombotic changes, and incompetence of the superficial and perforating venous system. Additionally, descending venography was performed in the first 52 limbs and compared to color coded duplex sonography in the diagnosis of deep and superficial venous reflux. Variant venous anatomy (21 cases) was missed in two limbs and misinterpreted in one limb by ascending venography compared to surgery. Color coded duplex sonography was inconclusive in two cases. Variant varicosis (59 cases) was missed in seven surgically proved cases by venography and in one case by color coded duplex sonography. Color coded duplex sonography was inconclusive in five cases. Ascending venography was slightly superior to color coded duplex sonography in the detection of postphlebitic changes. Good agreement was found between color coded duplex sonography and descending venography in the grading of superficial (k = 0.75) and deep venous reflux (k = 0.79). Excellent agreement was found between ascending venography in the grading of long (k = 0.96) and short (k = 0.94) saphenous vein reflux. More incompetent perforating veins were detected by ascending venography, (and varicography) than by color coded duplex sonography, but the latter technique allows direct preoperative marking of the skin, which is beneficial for the surgeon. We conclude that color coded duplex sonography is a valuable imaging tool before venous stripping and is capable of replacing invasive ascending and descending venography. Only patients with inconclusive color coded duplex sonographic results (e.g., complex variant venous anatomy) should proceed to venography.     

Deep vein thrombosis and systemic inflammatory response: a pilot trial

INTRODUCTION: Symptoms of deep vein thrombosis as swelling, erythema, pain and calor have been suspected of being caused by an inflammatory reaction of the affected leg. We therefore performed a prospective pilot trial to study a possible systemic inflammatory response induced by deep vein thrombosis. PATIENTS AND METHODS: We determined white blood cell count and plasma C-reactive protein in 100 consecutive patients with suspected deep vein thrombosis. The final diagnosis was based on the results of duplex sonography or ascending venography. RESULTS: Deep vein thrombosis was diagnosed in 37 patients (37%). White blood cell count (P = 0.012) and plasma C-reactive protein values (P < 0.001) were significantly increased in patients suffering from deep vein thrombosis. There was no correlation of white blood cell count or C-reactive protein with the thrombotic burden or the duration of symptoms. CONCLUSION: In patients with deep vein thrombosis, thrombus formation and consequent vein wall damage induce a systemic inflammatory reaction which is reflected by significantly increased levels of white blood cells and plasma C-reactive protein.     

Compression sonography as a procedure in the diagnosis of acute deep venous thrombosis of the leg

It is well known that clinical symptoms of deep venous thrombosis of the leg are not reliable. We studied the diagnostic value of compression sonography in the diagnosis of venous thrombosis of the lower extremity. Ultrasound examination was performed in patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh lacking compressibility of the venous lumen was the only criterion for thrombosis. In the calf, unobstructed veins can usually not be seen in the patient supine. In thrombosis however the vessel is dilated by the clot and appears as sonolucent incompressible channel. 178 patients were examined comparatively by venography and ultrasound (226 one extremity phlebogramms). Phlebography demonstrated 113 thromboses which could be demonstrated by ultrasound with a sensitivity of 95% and a specificity of 100%. In 92% the extension of thrombosis was estimated accurately. Thigh vein thrombosis was detected with a sensitivity of 97% and a specificity of 99%. Occlusion or patency of the common femoral vein was seen correctly in each case. Ultrasonic diagnosis of the superficial femoral vein thrombosis had a sensitivity of 97%, that of the popliteal vein of 98% and a specificity of 100% in both. Venous occlusion confined to the calf was detected with a sensitivity of 89% and a specificity of 99%. We conclude that compression sonography is a highly accurate diagnostic procedure for the diagnosis of deep venous thrombosis of the thigh as well as the calf. It should be the first choice of imaging method in the diagnosis of venous thrombosis of the leg.     

多层螺旋CT静脉造影诊断下肢静脉血栓性病变

目的探讨多层螺旋CT静脉造影(MSCTV)对下肢静脉血栓诊断的临床应用价值.方法 MSCT下肢静脉造影检查16例,其中12例做下肢多普勒超声检查,4例做下肢静脉造影.MSCTV检查后经最大密度投影(MIP)、表面遮盖法(SSD)及容积再现法(VR)重建.结果 MSCTV显示11例存在静脉血栓.以多普勒超声作对照,MSCTV显示股腘静脉血栓的敏感性96.0%,特异性97.8%,阳性预测值96.0%,阴性预测值97.8%,准确性97.2%.MSCT尚能显示小腿、盆腔等超声检查难于显示的血栓.MSCTV较常规静脉造影更清晰显示盆腔静脉血栓.结论 MSCTV对显示股腘静脉血栓方面与超声同样敏感,MSCTV还能显示超声难于显示的髂静脉及胫腓静脉的血栓.MSCTV可作为下肢静脉血栓诊断的首选检查方法.     

Assessment of D dimer assays for the diagnosis of deep vein thrombosis

Sixty-two patients with suspected deep vein thrombosis were subjected to venography and to plasma D dimer assay by both rapid latex agglutination and enzyme immunoassay methods. The latex agglutination method was insensitive to the presence of deep vein thrombosis. In contrast, the enzyme immunoassay method was sensitive although of low specificity and for technical reasons not suitable for performance as an emergency test.     

CT静脉血管成像诊断下肢深静脉血栓的应用进展

下肢深静脉血栓是在下肢深静脉内血液发生凝固、形成血栓的一种临床常见疾病.传统的静脉造影术和多普勒超声是以往临床常用的诊断下肢深静脉血栓的检查方法.近年来,随着MSCT的临床普及,CT静脉血管成像已成为诊断下肢深静脉血栓的有效方法.本文就CT血管成像技术在下肢深静脉血栓的临床诊断和评估方面的应用进展做一综述.     

Deep venous thrombosis: detection by probe compression of veins

The sonographic detection of echogenic, soft-tissue mass within the veins of the lower extremities assures the diagnosis of deep venous thrombosis (DVT). However, the sonographic diagnosis remains inconclusive when fresh thrombus and/or artifacts are present within the lumen of the vein. The present study attempts to augment the clinical utility of real-time sonography in the detection of DVT, based on the premise that total obliteration of the vein lumen by probe compression should not be possible in the presence of venous thrombi. Sonography and contrast venography of the lower extremity were performed in 20 patients with clinical suspicion of DVT. The presence of thrombi was confirmed in 14 patients. Probe compression failed to obliterate the lumen of the veins containing thrombi. The authors conclude that the technique of probe compression is useful for rapid and noninvasive detection of venous thrombi.     

超声诊断高原地区肺动脉栓塞的临床价值

目的探讨超声在诊断高原地区肺动脉栓塞中的临床价值。方法分析29例超声检查并经临床证实的高原地区的肺动脉栓塞患者的声像图特征。结果超声心动图异常者24例,显示肺动脉收缩压不同程度增高,21例发生右心系统形态改变;超声发现下肢深静脉血栓13例,右颈部静脉血栓1例,右上肢深静脉血栓2例。结论声像图的直接和间接征象对快速早期诊断肺动脉栓塞具有重要的临床价值。     

彩色多普勒超声诊断下肢深静脉血栓的应用价值研究

目的探讨彩色多普勒超声诊断下肢深静脉血栓的应用价值。方法 90例下肢深静脉血栓患者均接受彩色多普勒超声检查,采用GE LOGIQ E9彩色多普勒超声诊断仪,依次检查双侧髂总静脉、髂外静脉、股静脉、腘静脉、胫后静脉、胫前静脉及其分支,观察下肢深静脉血栓分布情况及各种血栓声像图特征。结果①90例患者中,共显示103条患肢存在下肢深静脉血栓,其中单侧77例,双侧13例,左侧74条(71.84%),右侧29条(28.16%)。股静脉血栓比率最高,为32.04%;其次为髂静脉及股静脉,为21.36%;髂静脉比率最低,为4.85%。②超声图像显示急性血栓呈均匀低回声,静脉管腔闭塞或部分堵塞,病变处管腔增宽,管壁光滑。超声图像显示慢性血栓呈不规则形强回声,静脉管腔闭塞或部分堵塞,病变处管腔变小,管壁局限性或弥漫性增厚,内壁毛糙。结论彩色多普勒超声在下肢深静脉血栓的诊断中具有很高的应用价值。     

MR assessment of the extremity veins

This article provides an overview of the technique of magnetic resonance venography (MRV) and its relative value in the diagnostic work-up of suspected lower or upper extremity venous thrombosis. MRV is accurate for diagnosis or exclusion of deep vein thrombosis. MRV should be considered complimentary, in many instances, to the less expensive modality of venous sonography. It is the complimentary use of magnetic resonance techniques at the level of the pelvis and the mediastinum that offers the greatest cost benefit as part of an incremental strategy for the work-up of patients presenting with lower or upper extremity swelling.