下肢深静脉血栓超声不同方法的对比研究

本文对４４例临床疑诊下肢深静脉血栓（ＤＶＴ）患者进行了二维彩色多普勒血流显像（２Ｄ－ＣＤＦＩ）和上行性静脉造影对比，旨在评估超声不同方法诊断ＤＶＴ的准确性。超声诊断ＤＶＴ的方法包括：血栓回声法（ＴＨ法）、探头加压法（ＣＯＭ法）、脉冲Ｄｏｐｐｌｅｒ法（ＰＤ法）和彩色Ｄｏｐｐｌｅｒ法（ＣＤ法）。３０条静脉造影确诊为ＤＶＴ，１４条阴性。单一指标以ＣＯＭ法最好，敏感性为９０．０％、特异性９２．８％和准确性９０．９％；不同指标联合以ＣＯＭ＋ＰＤ＋ＣＤ和ＴＨ＋ＣＯＭ＋ＰＤ＋ＣＤ法最佳，其敏感性均为９６．７％、特异性１００％和准确性９７．６％。超声是无创伤性评价下肢ＤＶＴ的敏感方法，全方位检查可更准确地诊断ＤＶＴ。

The Ultrasonic Method for Diagnosing Deep Venous Thrombosis of the Lower Limbs

Forty four patients clinically suspected to have deep venous thrombosis(DVT)were examined by 2D CDFI and ascending phlebography.Ultrasonic criteria for diagnosis included visualization of thrombus(TH),incompressibility of the vein with probe pressure(COM),absence of spontaneous flow or phase flow with respiration by pulse Doppler(PD),and absence of color flow signal or presence of intraluminal filling defect by color Doppler(CD).Phlebography was positive in 30 patients and negative in 14 patients.The best single index was COM(sensitivity=90 0%,specificity=92 8%,accuracy=90 9%).The best combination indexes was COM PD CD and TH COM PD CD,the same results were achieved(sensitivity=96 7%,specificity=100%,accuracy=96 7%).Ultrasound is a noninvasive and sensitive method,2D CDFI examination may be more accurate for diagnosing DVT.