小腿静脉血栓的影像学诊断  

Imaging diagnosis of deep venous thrombosis in the calf

作　　者：张晓蓉[1] 何文[1] 唐华[1] 梁晓宁[1] 徐利群[1] 戴可定[2] 高堃[2] 

机构地区：[1]首都医科大学附属北京朝阳医院超声影像科,北京100020 [2]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中国医学影像技术》2004年第7期1064-1067,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家"十五"攻关课题资助项目 (2 0 0 1BA 70 3B1 3)

摘　　要：目的　探讨彩色多普勒超声及静脉造影对小腿静脉血栓的诊断价值。方法　采用彩色多普勒超声检出 2 19例小腿静脉血栓 ,其中 18例行下肢静脉造影。结果　彩色多普勒超声检查出小腿陈旧性或附壁血栓 15 2例 ,新鲜血栓 67例。与静脉造影对照 ,彩色多普勒超声检测小腿胫后静脉、腓静脉的敏感性分别为 87.5 %、90 .9% ,特异性分别为 10 0 %、10 0 % ,而对于小腿腓肠肌和比目鱼肌间静脉血栓 ,彩色多普勒超声的诊断显示率明显高于静脉造影。小腿静脉血栓发生于单侧肢体者明显多于同时发生于双侧肢体者。两侧小腿血栓分布部位的次序都是腓静脉 (2 8% ) >胫后静脉 (2 3 .0 % ) >肌间静脉 (15 .1% ) >肌间静脉 +腓静脉 (14 .6% )。结论　彩色多普勒超声对小腿胫后、腓、胫前静脉、腓肠肌和比目鱼肌间血栓有较高的敏感性和特异性 ,可以了解小腿静脉血栓的发生部位、分布、延伸和大小的变化。静脉造影可以确诊胫后、腓、胫前静脉的血栓 ,但对小腿肌间静脉血栓的诊断有限。Objective To discuss the diagnostic value of color Doppler ultrasound (CDUS) and venography in deep venous thrombosis of isolated calf veins. Methods From Jan. 2001 to Jan. 2004, 219 cases of isolated venous thrombosis in the calf were diagnosed by CDUS, 18 cases performed venography. Results One hundred and fifty-two cases of stale thrombosis and 67 cases fresh thrombosis were found by CDUS. Compared with venography, CDUS showed a sensitivity of 87.5% in posterior tibial vein and 90.9% in peroneal vein, a specificity of 100% and 100%, respectively. The incidence of thrombosis in calf vein in one leg was higher than that in both legs. The distributed order of thrombosis in calf vein was peroneal vein (28%) > posterior tibial vein (23.0%) > muscular vein (15.1%) > muscular vein + peroneal vein (14.6%). Conclusion CDUS showed a high sensitivity and specificity in peroneal vein and posterior tibial vein. It can be used to detect the patterns and distribution of thrombosis in calf veins. Venography could detect the thrombosis in posterior tibial veins, peroneal veins and anterior tibial veins, but it is limited to detect the soleal and gastrocnemius venous thrombosis.

关 键 词：彩色多普勒超声 静脉造影 静脉血栓 小腿 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]