彩色多普勒血流显像在检查下肢深静脉血栓中的应用

目的：探讨彩色多普勒血流显像在诊断下肢深静脉血栓中的价值。材料和方法：对３５例下肢深静脉血栓患者进行彩超检查，年龄２５～７２岁，平４６８岁，其中２６例被Ｘ线静脉造影证实，２例手术证实。结果：下肢深静脉血栓的声像图特征是静脉管腔内出现实性回声，探头加压管腔不能被压瘪；彩色多普勒显示病变处缺乏血流信号或血流信号消失；脉冲多普勒显示频谱异常，即不随呼吸变化。结论：彩色多普勒血流显像具有操作简单，无创伤，可重复检查等优点，是检查下肢深静脉血栓的敏感方法。     

彩色多普勒超声诊断下肢深静脉血栓157例

目的：分析彩色多普勒超声检查对下肢深静脉血栓的诊断。方法：于2009-01-12应用彩色多普勒超声检查发现下肢深静脉血栓患者157例。结果：本组病例中急性下肢深静脉血栓125例,陈旧性下肢深静脉血栓32例,应用彩色多普勒超声检查均能清晰显示病变部位、血栓回声及血流状况等,为及时治疗疾病、减少并发症的发生提供了重要依据。结论：彩色多普勒超声检查具有准确性高,为诊断下肢深静脉血栓首选检查方法。     

彩色多普勒超声诊断下肢深静脉血栓的价值研究

目的：探讨彩色多普勒超声对下肢深静脉血栓形成的诊断价值。方法：应用彩色多普勒超声诊断仪检查临床拟诊为下肢深静脉血栓87例,观察静脉管腔内回声、血栓形成的范围、血流分布及频谱特征。结果：观察发现,左下肢静脉血栓发生率显著高于右侧;彩色多普勒超声可表现为腔内强弱不等回声和充盈缺损,显示无血流信号或血流频谱不随呼吸变化。结论：彩色多普勒超声对下肢深静脉血栓的诊断具有简便、快速、无创、可靠等特点,可作为首选方法,为临床治疗及疗效评价提供可靠依据。     

彩色多普勒超声检测下肢深静脉血栓的探讨

目的　探讨彩色多普勒超声 (CDFI)检测下肢深静脉血栓的应用价值。方法　对下肢深静脉血栓的 10 1例患者 (118条患肢)进行彩色多普勒超声检测及上行静脉造影检查。结果　与造影对比彩色多普勒超声诊断敏感性为 94 4 % ,准确性为 98 4 % ;股静脉血栓最多见 (30 4 % ) ;左侧明显多于右侧 ,比例为 2 2∶1;急性、亚急性 ,慢性血栓的病理改变不同 ,超声显像亦有差别。结论　CDFI可诊断各时期下肢深静脉血栓 ,是一种无创、快捷、准确的检查方法     

60例下肢深静脉顺行造影的X线分析

目的：分析下肢深静脉顺行造影的X线表现及其临床应用的价值。方法分析对60例（60例单肢体）全部采用下肢深静脉的顺行造影的X线影像资料。结果 X线影像显示,下肢深静脉血栓伴侧枝循环形成13例（26％）,下肢交通静脉瓣功能不全18例（36％）,深静脉瓣膜功能不全12例（24％）,单纯大隐静脉曲张及静脉瘤样病变7例（14％）。结论下肢深静脉造影能较准确的做出对下肢静脉病变的诊断,为临床诊断及治疗提供了重要的X线影像学依据。并对选择合适的治疗方法以及疗效的观察有着重要的临床应用价值。     

直接法多层螺旋CT静脉造影诊断下肢深静脉血栓简

目的：探讨直接法多层螺旋CT静脉造影（MSCTV）诊断下肢深静脉血栓的临床应用价值。方法直接法多层螺旋CT（MSCT）下肢静脉造影17例,同期均行彩色多普勒超声血流显像（CDFI）检查。直接法MSCTV检查后,所得图像经处理后传送至工作站进行多平面重建（MPR）、最大密度投影（MIP）、表面遮盖（SSD）及容积再现（VR）重建。结果直接法MSCTV检查显示13例存在下肢深静脉血栓（DVT）,彩色多普勒超声检查显示10例,2例髂静脉及1例胫腓静脉血栓彩色多普勒超声未能检出。直接法MSCTV上DVT主要表现为静脉腔内造影剂充盈缺损、静脉节段性不显影、栓塞静脉远端扩张及其周围侧支循环静脉迂曲扩张、周围软组织肿胀、皮肤增厚。结论直接法MSCT能清晰显示DVT形成的部位、范围、侧支静脉情况及病变血管周围的解剖结构,对彩色多普勒超声不易检出的盆腔及小腿深静脉栓塞也能清晰显示,可以作为下肢深静脉血栓检查的常规方法。     

彩色多普勒超声诊断下肢深静脉血栓临床分析

目的探讨彩色多普勒超声诊断下肢深静脉血栓效果。方法选取疑似下肢深静脉血栓患者100例作为观察对象,对其进行彩色多普勒超声检查,与深静脉造影检查结果进行统计对比分析。结果 100例临床可疑下肢DVT患者中,彩色多普勒超声诊断阳性75例,诊断率75%,对比两种检查方式行一致性检验,Kappa为0.7590.05,表明两种影像学方法诊断下肢DVT有较高的一致性,无统计学意义。结论彩色多普勒超声诊断下肢深静脉血栓临床效果明显,操作简单。     

下肢深静脉造影的X线影像分析

目的：分析下肢深静脉造影的X线影像表现，评价其对临床的应用价值。材料与方法：对238例全部采用下肢深静脉顺行造影，用X线影像动态观察和数字摄片检查。结果：原发深静脉膜功能不全132例(55．46％)、下肢静脉血栓、形成后遗症53例(22．27％)。单纯性下肢静脉曲张39例(16．39)。其他疾病14例(14．58％)。结论：下肢深静脉造影在X线数字影像中能完整地记录静脉显示过程，同时能较清晰地显示下肢静脉病变位置和范围：     

彩色多普勒超声在诊断下肢深静脉血栓形成后继发性动静脉瘘形成中的临床价值

目的探讨彩色多普勒超声血流显像在诊断下肢深静脉血栓形成后深静脉血管腔内多发动静脉瘘形成的临床价值。方法收集下肢深静脉血栓腔内继发性动静脉瘘患者59例,行双侧下肢深静脉彩色多普勒超声检查,对确定的病变位置和范围,测量最大流速,阻力指数。结果本组59例病例中累及髂外静脉者18例,股总静脉15例,股浅静脉12例,腘静脉7例,肌间静脉6例,其中1例发生于浅静脉血管腔内,病变血管血栓再管化率低于10%,血管阻力指数为0.33～0.48。结论下肢深静脉血栓形成后深静脉血管腔内多发动静脉瘘形成在彩色多普勒超声现象中具有特征性表现,是诊断本病的首选影像学检查方法。     

彩色多普勒超声在下肢深静脉血液高凝状态的临床应用价值

目的：早期发现、早期诊断下肢静脉血栓,分析和探讨彩色多普勒超声在下肢深静脉血栓形成前期的应用价值。方法：通过分析156例经彩色多普勒超声检查四肢深静脉血栓形成及血栓形成前期的图像特点及临床治疗经过与疗效复查情况。结果：彩超检查下肢深静脉血管可了解血管的形态结构、管腔血栓形成的程度及彩色血流动力学等改变。及早发现血液高凝状态即血栓前期,并在血栓形成之前及时采用药物治疗,达到临床治愈。结论：彩超检查对四肢深静脉血栓的形成具有很高的敏感性和特异性,是一种可靠的诊断依据,对临床治疗有较好的指导作用。     

Symptomatic lower extremity deep venous thrombosis: accuracy, limitations, and role of color duplex flow imaging in diagnosis

Color duplex flow imaging (CDFI) permits pain- and risk-free direct imaging of the deep venous system of the lower extremities. To prospectively ascertain the accuracy and limitations of this technique, CDFI was performed in 75 lower limbs of 69 consecutive patients referred for venographic evaluation of clinically suspected lower extremity deep venous thrombosis (DVT). The CDFI study was obtained within 24 hours of the contrast venogram. Both studies were interpreted without knowledge of the patient's clinical findings or the results of the other test. Contrast venography was regarded as the standard for diagnosis of DVT. Accuracy was 99% for detection of DVT above the knee and 81% below the knee. Sonographic evaluation of the calf veins was technically adequate in 60% of limbs; accuracy was 98% in this group. In the 40% of limbs with technically limited CDFI studies of the calf, accuracy decreased to 57%. Although small nonocclusive thrombi occurred infrequently in this series of symptomatic patients, CDFI missed three of four such thrombi. It is concluded that CDFI, when not technically compromised, is sufficiently accurate to definitively diagnose symptomatic lower extremity DVT.     

二维及彩色多普勒血流显像诊断下肢静脉病变的意义

目的 评价彩色多普勒血流显像检测临床下肢静脉病变的应用价值。方法 对临床下肢静脉病变90例107条下肢静脉进行彩色多普勒血流显像检查。结果 彩色多普勒血流显像可迅速清晰地显示下肢的解剖图像，其中检出61例64条下肢静脉有血栓形成（急性血栓31例，慢性血栓30例），8例9条深静脉瓣功能不全，31例34条为下肢静脉曲张。结论 下肢深静脉血栓形成有一定的声像特征，彩色多普勒血流显像检出敏感性高，可对血栓作出定位，定范围和管腔阻塞程度的判断，是帮助临床选择治疗方案和客观评价药物疗效的重要方法。判断有无深静脉功能不全，可为临床手术和治疗提供可靠依据。     

下肢深静脉血栓的彩色多普勒超声诊断

目的：探讨彩色多普勒超声(CDFI)对下肢深静脉血栓(DVT)的诊断要点和临床价值。方法：对30例共34条患肢进行彩超检查，分析其类型、声像图特征，并与X线血管造影进行对照。结果：30例患者中左侧血栓22例(73．0％)，右侧4例(13．3％)，左右侧同时发病4例(13．3％)。34条患肢中中心性血栓18条(53．0％)，外周性8条(23．5％)，广泛性8条(23．5％)。34条受累静脉均有不同程度的扩张且探头加压无管腔压瘪(100％)。急性血栓为均匀低回声，不均匀偏高回声多提示为慢性血栓。CDFI显示受累静脉内血流信号消失或仅有少量溪流。结论：CDF1可为下肢DVT的检出、分类等提供可靠的诊断依据。     

Underassessment of lower extremity deep venous thrombosis using color flow Doppler compared to compression sonography

The aim of this paper is to compare the accuracy of color Doppler to compression sonography in the diagnosis of lower extremity deep vein thrombosis. Longitudinal color flow imaging was performed in 60 lower extremities in patients with clinically suspected deep venous thrombosis (DVT). The study was then repeated by a blinded examiner using transverse compression sonography. The results were then correlated. Thirty-five examinations were negative by both color flow and compression methods. Twenty thrombi were diagnosed on compression sonography, while only 13 were diagnosed by the color flow method. Thirty-five percent of thrombi were missed using color flow imaging alone. We conclude that compression sonography should remain an integral part of the assessment of lower extremity DVT, as a significant number of thrombi might be overlooked using longitudinal color flow imaging alone. This is especially true in non-occlusive thrombi that are adherent to the vessel wall.     

Deep venous thrombosis of the lower extremity: US evaluation

The sensitivity of duplex ultrasonography (US) for detecting deep venous thrombosis of the lower extremity was compared with that of venography in a prospective study of 54 patients. Doppler analysis of the common femoral vein and US imaging of the deep venous system from the common femoral vein to the popliteal vein was performed. Common femoral vein response to the Valsalva maneuver was recorded. Sonographically visible thrombi and abnormal vein compressibility were 91% sensitive for the common femoral vein, and 94% sensitive for the superficial femoral or popliteal veins, with no false-positive examinations. Abnormal Doppler flow and abnormal response of the common femoral vein to the Valsalva maneuver enabled thrombi to be detected only in the common femoral and iliac veins. Combined data allowed accurate diagnoses in all patients with deep venous thrombosis proximal to the deep calf veins. US should be the screening examination of choice for evaluating patients with suspected lower extremity deep venous thrombosis.     

急性下肢深静脉血栓形成的多普勒超声诊断与手术对照

目的 :探讨常规超声和彩色多普勒超声 (CDFI)对急性下肢深静脉血栓形成 (DVT)诊断的价值。方法 :对 94例急性DVT病例进行了常规超声和CDFI检查并经手术证实。结果 :DVT声像表现为静脉内径增宽 ,腔内实质回声 ,按压静脉未变形 ,静脉瓣固定等 ,彩色多普勒可无血流信号或腔内充盈缺损确诊。本组病例均经手术证实 ,无一误诊。结论 :彩色多普勒与常规超声联合应用为诊断急性DVT的首选方法     

Distribution of thrombi in acute lower extremity deep venous thrombosis: implications for sonography and CT and MR venography

OBJECTIVE: Our objective was to determine the typical distribution of thrombi in acute lower extremity deep venous thrombosis as a means of evaluating the validity of imaging techniques that only include the common femoral and popliteal veins, but not the superficial femoral vein. MATERIALS AND METHODS: The results of 2704 lower extremity venous sonograms, obtained in 2026 consecutive patients over a 4-year interval, were reviewed retrospectively. The distribution of acute deep venous thromboses across various lower extremity venous segments was analyzed for this population, which consisted of both symptomatic and asymptomatic patients. RESULTS: Of 2704 lower extremities studied with duplex sonography, acute deep venous thrombosis was identified in 269 (9.9%). Of these 269 cases, acute deep venous thrombosis was isolated to the superficial femoral vein in 60 (22.3%). The remaining 209 cases (77.7%) showed thrombus that extended into the common femoral or popliteal veins (or both). CONClUSION: An abbreviated imaging study that evaluates only the common femoral and popliteal veins would fail to identify more than 20% of lower extremity acute deep venous thromboses in a population like ours. Although evaluation of the superficial femoral vein requires additional time and resources, evaluation of this segment may prevent a substantial number of thrombi from being missed.     

彩色多普勒血流显像诊断下肢深静脉血栓

目的：探讨彩色多普勒血流显像（ＣＤＦＩ）诊断下肢深静脉血栓（ＤＶＴ）的准确性。资料与方法：对４４例４４条下肢临床疑诊为ＤＶＴ进行ＣＤＦＩ和上行性静脉造影对比。结果：３０条静脉造影确诊为ＤＶＴ,ＣＤＦＩ诊断准确２９条,１４条小腿静脉血栓为假阴性。１４条下肢静脉造影示正常,ＣＤＦＩ亦未见异常。ＣＤＦＩ诊断ＤＶＴ的敏感性为９６．７％,特异性１００％,准确性９７．６％。结论：ＣＤＦＩ是无创伤性检查ＤＶＴ敏感且准确的方法。     

Assessment of deep venous thrombosis using routine pelvic CT.

OBJECTIVE: The purpose of this study was to assess routine pelvic CT both for accuracy in diagnosis of deep venous thrombosis and for frequency of detection of clinically unsuspected pelvic thrombi. MATERIALS AND METHODS: We reviewed the CT records of patients who had undergone pelvic CT during a 6-month period and cross-referenced these records to reports on lower extremity venous sonography to identify patients who had undergone this test within 1 week of pelvic CT. We compared the frequency and location of venous thrombosis revealed through these two tests. To identify unsuspected deep venous thrombosis detected on pelvic CT, we reviewed the charts of patients for whom a clot was reported to determine if it had been clinically suspected before CT. RESULTS: Among the 52 patients who underwent both CT and lower extremity venous sonography, the findings were in agreement for 49 (94%). The techniques disagreed for three patients; two patients had deep venous thrombosis detected on sonography but not on CT and the other had a clot detected on CT but not on sonography. The prevalence of unsuspected deep venous thrombosis detected by CT was 1.1%, and 73% of these patients underwent anticoagulation therapy without further confirmatory tests. CONCLUSION: Unsuspected deep venous thrombosis is commonly seen on routine pelvic CT and should be carefully sought during such examinations. CT appears to be relatively accurate in the detection of deep venous thrombosis. Thus, CT venography combined with pulmonary CT angiography may significantly increase the percentage of patients who are appropriately treated for thromboembolic disease because both deep venous thrombosis and pulmonary emboli can be identified by this combined test.