下肢深静脉瓣膜关闭功能不全的影像学诊断

目的研究下肢静脉瓣膜关闭功能不全影像学分型及对外科手术的意义。方法458条肢体均做下肢深静脉顺行造影,其中361条肢体行经皮腘静脉插管造影,并对14条单纯性大隐静脉曲张(正常瓣膜)肢体进行血液动力性观察。结果444条肢体诊断为下肢静脉关闭下全,14条肢体诊断为单纯型大隐静脉曲张,其中,Ⅰ型深静脉瓣膜脱垂致瓣膜关闭不全114例;Ⅱ型深浅静脉扩张致瓣膜相对关闭不全121例;Ⅲ型瓣膜脱垂加股静脉扩张125例;Ⅳ型先天性下肢深静瓣膜发育不全症4例;Ⅴ型深静脉血栓形成后完全再通瓣膜遭破坏71例;Ⅵ型先天性静脉畸形、组织肥大综合征(Klippel-Trenaunay,KTS)9例;14条单纯性大隐静脉瓣膜均完全正常,屏气时正常肢体股静脉第一对瓣膜、腘静脉瓣膜同时关闭,足背伸屈运动时腘静脉瓣膜开放程度显著大于股静脉第一对瓣膜(P＜0．01)。结论下肢深静脉瓣膜关闭功能不全分型能全面反映疾病的病理本质,较下肢深静脉瓣膜功能不全的概念更确切。

Imaging diagnosis of deep vein valve closure insufficiency in lower extremities

Objective To assess the typing and imaging diagnosis of deep vein valve closure insufficiency in lower limbs.Methods 458 stick limbs and trunks were subjected to lower limb deep vein contrast-graphy,361 sticks lower limb to intubate vena poplitea radiography and 14 sticks limbs and trunks with simple form varicosis of great saphenous vein to march hematodynamics.Results 444 sticks limbs and trunks were diagnosed as lower limd deep vein closure insufficiency.I type:114 cases, deep vein valve prolapse;Ⅱtype:121 cases superficial femoral vein dilation lead to valve incompetence;Ⅲtype:125cases,valve prolapse consolidation superficial femoral vein ilation;Ⅳtype:4 cases,valve aplasia congenitalis;Ⅴtype:71 cases,thrombophoebitis;Ⅵtype:9 cases,Klippel-Trenaunay syndrome.The 14 cases of simple form varicosis of great saphenous sticks normal valve,during breath holding valve of simple form varicosis of great saphenous simutaneous closure,instep outreach and atcuation,valve of vean poplitea open more than valve of simple form varicosis of great saphenous vain (P＜0.01).Conclusion Deep vein valve closue insufficiency in lower extremities reflects pathologic process of disease.