二维及彩色多普勒超声观察急性下肢深静脉血栓形成及其演变

目的应用二维及彩色多普勒超声观察下肢深静脉血栓形成各期的声像图特征及临床转归。方法应用彩色多普勒超声检测19例拟诊为急性下肢静脉血栓患者，测量下肢深、浅静脉管径、血栓大小、范围、血流变化，检测静脉瓣功能，定期随访观察各参数的变化。结果19例急性血栓形成患者入院初诊患肢深静脉内径较健肢明显增宽，股静脉(12.9±2.7)mmvs(9.2±2.1)mm,P＜0.001；静脉(8.8±1.2)mmvs(5.9±1.5)mm,P＜0.001)，管腔内呈低回声，CDFI未显示血流信号或有血流充盈缺损。治疗2周～1月后，患肢有不同程度的再通和改善，血栓回声有所增强，内径变化较初诊仍不明显；6个月以后复查静脉管壁、血栓的回声明显增强，较前比较内径明显减小，股静脉(10.1±1.7)mm，P＜0.01；静脉(6.4±0.9)mm，P＜0.001。CDFI血流呈“轨道征”等改变。结论血栓形成的不同时期超声表现各有不同。彩色多普勒超声可诊断急性深静脉血栓形成，动态观察其演变过程，具有其他影像学不可替代的优势。

Follow-up Study on Deep Venous Thrombosis of Lower Extremities by Two-dimensional Ultrasonography and Color Doppler Flow Imaging

Objective:To observe the evolvement of acute deep venous thrombosis with two-dimensional ultrasonography(2D)and color Doppler flow imaging(CDFI).Methods：Ninteen patients suspected as acute deep venous thrombosis were examined by 2D and CDFI.The symptoms,the location,the size and the blood flow etc.were detected and analysed.All these cases were followed up 1 to 6 months after clinical treatment respectively.Results:There were luminal dilations of the femoral vein(12.9±2.7mm vs 9.2±2.1mm，P＜0.001)and the popliteal vein(8.8±1,2mm vs 5.9±1.5mm,P＜0.001)in the acute stage of all cases compared to the healthy extremity.There were low echoes in the thrombosed segments by 2D and no blood flow signals by CDFI.After 2 weeks treatment,recanalization could be found in the involved lumens but no evident differences were shown in the luminal diameters.After 6 months the reduction of the diameter was statistically significant:femoral veins(10.1±1.7mm，P＜0.01)and popliteal veins(6.4±0.9mm,P＜0.001).The thrombotic echoes were enhanced and color blood flow menifested “railway sign”.Conclusions:There was characteristic ultrasonic imaging in each different stage of thrombosis.CDFI can be used to observe evolvement of acute deep venous thrombosis dynamically and is prior to other medical imaging technology.