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。     

彩色多普勒超声对下肢静脉血栓的诊断价值

目的探讨彩色多普勒超声检查对下肢静脉血栓形成的诊断价值。方法应用多普勒超声检查对46例确诊为下肢静脉血栓患者和40例同期住院的非下肢静脉血栓患者的下肢静脉血管形态、静脉管壁平滑度、各静脉的管径、管腔内回声情况和有无血栓、管腔狭窄或闭塞及血流动力学改变进行比较。结果观察组(46例)单支静脉受累9例(19.57%),2支静脉受累17例(36.96%),3支以上静脉受累20例(43.48%);观察组股、腘静脉管径均较对照组粗(P<0.05);下肢血管病变程度对照组明显低于观察组(P<0.05)。结论彩色多普勒超声检查对下肢静脉血栓显示敏感,可作为下肢静脉血栓的首选检查方法。     

多普勒超声及实时剪切波弹性成像对静脉系统循证诊断效能的对比研究

目的：分析多普勒超声单独应用及联合实时剪切波弹性成像(shear wave elastography,SWE)对静脉系统的循证诊断效能。方法：选取2021年1—12月天水市第一人民医院收治的疑似下肢深静脉血栓患者200例。所有患者均进行多普勒超声检查和实时剪切波弹性成像检查。以下肢静脉造影结果为诊断标准,比较多普勒超声、多普勒超声联合SWE对下肢深静脉栓塞的诊断效能。根据下肢静脉造影的结果,将200例患者分为栓塞组(n=87)和非栓塞组(n=113),比较两组患者多普勒超声参数及实时剪切波弹性成像参数。结果：下肢静脉造影结果显示,200例患者中87例为下肢深静脉栓塞,多普勒超声联合SWE对下肢深静脉栓塞诊断的准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为95.50%、96.55%、94.69%、93.33%、97.27%,均高于单一多普勒超声检查的70.00%、62.07%、76.11%、66.67%、72.27%,差异有统计学意义(P <0.05)。栓塞组患者彩色多普勒检查显示股总静脉、胫后静脉、肌间静脉、股浅静脉直径均显著大于非栓塞组(P<0.01),两组患者腘静...     

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。     

彩色多普勒超声诊断小腿后肌间静脉血栓

目的探讨彩色多普勒超声对小腿后肌间静脉血栓的临床诊断价值。方法选择行膝关节或髋关节置换术患者72例共94肢,于术前行下肢静脉彩色多普勒超声检查,记录有无血栓并检测股静脉反流情况;术后14天行超声检查及顺行性下肢X线静脉造影。结果术后65肢分别经静脉造影和彩色多普勒超声检查,静脉造影发现3肢,彩色多普勒超声检查发现18肢小腿后肌间静脉内血栓形成,彩色多普勒超声对小腿后肌间静脉血栓的检出明显优于X线静脉造影。术前有反流的静脉中小腿肌间静脉血栓发生率57.14%(16/28);无反流的静脉中小腿肌间静脉血栓发生率17.78%(8/45),术前伴有股静脉反流的静脉血栓发生率高于正常静脉(P<0.01)。结论彩色多普勒超声检测小腿后肌间静脉血栓优于X线静脉造影,便于对血栓进行动态监测,可为临床治疗及疗效评价提供可靠的依据。     

小腿静脉血栓的影像学诊断

目的探讨彩色多普勒超声及静脉造影对小腿静脉血栓的诊断价值.方法采用彩色多普勒超声检出219例小腿静脉血栓,其中18例行下肢静脉造影.结果彩色多普勒超声检查出小腿陈旧性或附壁血栓152例,新鲜血栓67例.与静脉造影对照,彩色多普勒超声检测小腿胫后静脉、腓静脉的敏感性分别为87.5%、90.9%,特异性分别为100%、100%,而对于小腿腓肠肌和比目鱼肌间静脉血栓,彩色多普勒超声的诊断显示率明显高于静脉造影.小腿静脉血栓发生于单侧肢体者明显多于同时发生于双侧肢体者.两侧小腿血栓分布部位的次序都是腓静脉(28%)>胫后静脉(23.0%)>肌间静脉(15.1%)>肌间静脉 腓静脉(14.6%).结论彩色多普勒超声对小腿胫后、腓、胫前静脉、腓肠肌和比目鱼肌间血栓有较高的敏感性和特异性,可以了解小腿静脉血栓的发生部位、分布、延伸和大小的变化.静脉造影可以确诊胫后、腓、胫前静脉的血栓,但对小腿肌间静脉血栓的诊断有限.     

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。     

彩超对下肢骨折术前深静脉血栓筛查的意义

目的 探讨彩色多普勒超声筛查下肢骨折患者术前深静脉血栓的意义.方法 对580例单侧下肢骨折患者,术前应用彩色多普勒超声对下肢深静脉进行检测,观察有无血栓形成、累及部位、范围和活动度.结果 术前下肢深静脉血栓检出率为11.3％ (66/580),其中小腿肌间静脉血栓占40.9％ (27/66),严重的深静脉血栓(即股静脉至腘或胫后静脉、1例累及髂外静脉)占15.1％ (10/66);超声可显示血栓近端有活动度的8例.结论 下肢骨折患者易发生深静脉血栓,术前行彩色多普勒超声筛查,可早期检出下肢深静脉血栓的部位与活动度,对降低麻醉、手术风险,防止致命性肺栓塞具有重要意义.     

腹盆腔占位患者术前下肢静脉超声检查的临床价值

目的探讨下肢静脉彩色多普勒超声（CDFI）在腹盆腔占位患者术前的应用价值。方法对36例伴有下肢肿胀、疼痛等症状的腹盆腔占位患者术前行CDFI检查,测量股静脉的血流参数,检查有无下肢静脉血栓。结果受检患者中12例腹盆腔恶性肿瘤患者发生下肢静脉血栓（血栓组）,余24例虽未发生血栓（非血栓组）,但其股静脉血流速度均减低,平静呼吸时股静脉最大血流速度均〈14cm／s。结论对出现下肢症状的腹盆腔占位的围手术期患者,特别是恶性肿瘤患者术前应常规行CDFI检查,及时诊断下肢静脉血栓,给予临床干预,以保证手术安全进行,还可以对未形成血栓患者的下肢静脉血流淤滞状况给予提示。     

16层螺旋CT静脉成像技术在下肢深静脉血栓性病变的应用价值

目的:探讨16层螺旋CT静脉血管成像技术对下肢深静脉血栓性病变的诊断价值。材料与方法:通过16层螺旋CT对31例患者行16层螺旋CT静脉血管成像(MSCTV)检查,所有采集的原始数据导入ADW4.1高级后处理工作站,经最大密度投影(MIP)、多平面重组(MPR)、容积再现法(VR)重建,从而得到清晰而满意的临床诊断图像。结果:所有受检者血管重建显示良好,31例MSCTV检查中, 26例可显示不同部位、不同程度深静脉血栓形成。MSCTV主要征象包括:受累肢体肿胀,原始轴位图上血管腔内的充盈缺损,重建图像上显示管腔狭窄、中断或变细,明显浅静脉、侧支静脉扩张、纡曲。结论:16层螺旋CT静脉血管成像检查技术可以充分而准确地显示下肢静脉血栓性病变情况,并可显示静脉血管情况,有明显临床应用价值,优于多普勒超声及数字血管减影(DSA)检查,MSCTV可作为下肢静脉血栓性病变诊断的首选检查方法。     

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.     

直接法多层螺旋CT髂静脉成像诊断髂静脉压迫综合征

目的 探讨MSCT静脉成像(MSCTV)对髂静脉压迫综合征(IVCS)的诊断价值。 方法 对28例临床怀疑IVCS的患者先后行下肢深静脉顺行造影及直接法髂静脉MSCTV检查,评价两种方法对髂静脉的显示能力;以DSA或手术结果为"金标准",计算并比较两种检查方法诊断IVCS的敏感度及特异度。 结果 28例中,经直接法髂静脉MSCTV检查,髂静脉显示清晰26例,显示不清2例;经下肢深静脉顺行造影检查,髂静脉显示清晰19例,显示不清9例;差异有统计学意义(χ²=5.543,P=0.019)。直接法髂静脉MSCTV对IVCS的诊断敏感度及特异度分别为95.65%(22/23)、80.00%(4/5),下肢深静脉顺行造影的诊断敏感度及特异度分别为65.22%(15/23)、80.00%(4/5),敏感度差异有统计学意义(P=0.022)。 结论 直接法髂静脉MSCTV诊断IVCS具有较高敏感度,有助于检出IVCS。     

A prospective study of the efficacy of B-scan sonography in the detection of deep venous thrombosis in the lower extremities

Between 1 July and 31 December, 1985, 53 patients, clinically suspected of having deep venous thrombosis (DVT), were prospectively studied by B-scan ultrasound prior to lower-limb venography. Criteria for a positive ultrasound examination included visualization of frank clot, failure of the vein to collapse with compression, and absence of normal phasic flow with pulse Doppler sampling. All (100%) of the contrast venograms were considered of diagnostic quality. Fifty of the 53 ultrasound examinations (94%) were considered diagnostic. Of the 50 patients having venous ultrasound of diagnostic quality, contrast venography was positive in 25 and negative in 25 for DVT. Venous ultrasound was correct in 46 patients, for an accuracy of 92% (46/50). Sensitivity was 88% (22/25), specificity was 96% (24/25), the positive predictive value was 96% (22/23), and the negative predictive value was 89% (24/27). The single most useful sign of thrombosis in ultrasound examinations was the failure of the involved vein to collapse with compression. Venous ultrasound appears to be highly accurate in the detection of deep venous thrombosis of the lower extremity.     

Real-time sonography in deep thrombosis of the pelvic and leg veins. A prospective comparison to phlebography

Real-time B mode ultrasound is a well accepted diagnostic procedure in the non-invasive vascular examination. In a prospective study we examined 101 patients with clinical suspected deep vein thrombosis of the pelvis or leg using ultrasound and contrast venography within 24 hours and we compared the results of both examinations. All veins of the pelvis and lower extremities were scanned in transverse and longitudinal planes. 113 venograms were obtained; they demonstrated the presence of isolated proximal vein thrombosis in seven patients, seven isolated calf vein thromboses and 43 thromboses of both proximal and calf veins. The sensitivity of ultrasonography for detecting deep vein thrombosis in the proximal veins of the lower extremity was 98%, the specificity was also 98%. In the veins of the pelvis the sensitivity was 78%, the specificity 98% and in calf veins 60% and 97% respectively. The sensitivity for the detection of isolated calf vein thrombosis was only 14%. We conclude that ultrasonography has a very good sensitivity for detecting proximal vein thrombosis of the lower extremity and thrombosis of the pelvic veins. Phlebography remains the better method in detecting isolated calf vein thrombosis because of the difficult visualisation of the small calf veins by ultrasonography.     

间接下肢CT静脉造影检查的初步研究

目的评价间接下肢CT静脉造影检查在下肢静脉血栓诊断中的价值.方法本组共收集8例有下肢肿胀病例10人次行该方法检查.结果 10人次间接下肢CT静脉造影轴位像显示良好,依据静脉横径增粗和静脉内充盈缺损均可诊断下肢深静脉血栓.结论间接下肢CT静脉造影检查较下肢静脉造影术和超声在诊断下肢深静脉血栓方面有一定的优势,方法易行、易普及.     

Compression Sonography in the Diagnosis of Deep Venous Thrombosis of the Leg

The value of compression sonography was assessed to reduce the number of phlebographies otherwise necessary when deep venous thrombosis (DVT) is suspected among hospital patients. Compression sonography was used to study 119 prospective hospital patients who were suspected of having DVT of the lower extremity. The results were compared to those by phlebography. There were 44 DVTs detected by phlebography; ten of these were located only in the calf, below the knee. Of the remaining 34 femoropopliteal DVTs 33 were detected by the compression sonography technique. It is concluded that the use of compression sonography for primary investigation of suspected DVT reduces the number of patients who require phlebography to those whose results by compression sonography are negative. In our study, this would have represented a decrease of 28%, corresponding to a reduction of the total diagnostic costs by 10%.     

脑静脉窦血栓的影像学检查

目的评价脑静脉窦血栓形成(CVST)的影像检查方法。方法回顾性分析18例CVST患者的综合影像资料,18例均行常规CT和MRI平扫,6例行减影法多层螺旋CT脑静脉成像(MSCTV),13例行磁共振对比增强三维脑静脉减影法成像(3D CE-MRV),12例行DSA检查。结果 18例CVST患者中,经影像学检查发现上矢状窦CVST 8例,横窦2例,乙状窦4例,直窦2例,上矢状窦及乙状窦均受累2例。6例(33.3%)CT平扫可提供重要的影像表现,尤其是MSCTV更为直观。18例CVST患者MRI检查均可清晰显示脑静脉窦血栓形成导致的流空效应消失,静脉窦内出现各期血栓的不同信号,13例可见脑水肿、脑梗死、脑出血等间接征象。15例3D CE-MRV检查均发现CVST的血栓征象(静脉窦充盈缺损或中断)。12例行DSA检查均能获得明确诊断。结论 影像综合检查对CVST的早期发现、确诊及制订治疗方案具有重要价值。