腘血管陷迫综合征超声表现及误诊原因

目的 分析腘血管陷迫综合征(popliteal vascular entrapment syndrome,PVES)超声表现及误诊原因、防范措施.方法 回顾性分析6例PVES的临床资料.结果 PVES 6例中超声检查误诊1例,误诊率16.7％.6例均表现为患肢间歇性跛行,超声检查可见腘动脉近段向内侧不同程度移位,腘动静...

Analysis of the Ultrasonographic Manifestations and Causes of Misdiagnosis of Popliteal Vascular Entrapment Syndrome

Objective To analyze the ultrasonographic manifestations,causes of misdiagnosis and preventive measures of popliteal vascular entrapment syndrome(PVES).Methods The clinical data of 6 patients with PVES were analyzed retrospectively.Results Among the 6 cases of PVES,1 case was misdiagnosed by ultrasonography,with a misdiagnosis rate of 16.7%.All the 6 cases had a manifestion of intermittent claudication.Ultrasound examination revealed that the proximal segment of the popliteal artery shifted to the medial side,and the distance between popliteal arteries and veins widened.Of them,there was slight thickening of popliteal artery wall in 3 cases,and stenosis in 2 cases and lumen occlusion in 1 case.Positional stress tests(PST)were performed in 5 patients and all were positive.One case was misdiagnosed by ultrasonography as popliteal artery thrombotic occlusion with collateral formation and ischemic changes of the left posterior tibial artery and left dorsal artery.PST test was not performed.All 6 cases were diagnosed as PVES combined with clinical symptoms and imaging examinations,and all received surgical treatment.Among them,5 cases underwent popliteal artery lysis and 1 case underwent popliteal artery lysis and artificial blood vessel bypass surgery.During the follow-up of 1,3 and 6 months,the popliteal artery,bypass vessel,posterior tibial and dorsal foot arteries of the 6 affected limbs had smooth blood flow based on color Doppler ultrasound examination,and the claudication disappeared.Conclusion Ultrasonography is simple and non-invasive,which can reflect the PVES hemodynamic status,and provide important information for clinically defining the timing of surgery,determining the diagnosis and treatment strategy,and postoperative follow-up.In clinical practice,the advantages of various imaging examinations should be combined and complement each other to improve the accuracy of PVES diagnosis.