小腿肌间静脉丛血栓和腓肠肌血肿的超声诊断价值  

Ultrasonography in differentiation of calf muscular venous thrombosis and calf haematoma

作　　者：徐光[1] 苏里亚[1] 彭禹[1] 

机构地区：[1]卫生部北京医院超声科,北京100730

出　　处：《中国医学影像技术》2007年第5期741-743,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨彩色多普勒超声对鉴别诊断小腿肌间静脉丛血栓和腓肠肌血肿的价值。方法对24例小腿肌间静脉丛血栓和11例腓肠肌血肿的大小、形态和声像图特点进行回顾性对比分析。结果小腿肌间静脉丛血栓纵切为长管状、树枝状,横切为类圆形的低回声,与肌肉有整齐的分界,两端与静脉延续,多合并下肢深静脉主干的血栓。腓肠肌血肿体积较大,后方回声明显增强,与周围肌肉有高回声界限,血肿内无血流信号,多不合并下肢深静脉主干的血栓。早期为张力高的类圆形等回声或低回声,随之无回声区逐渐增多,张力减低,为卵圆形或梭形。肌肉撕裂伤引起的血肿部分肌纤维断裂,血肿占据肌肉的一部分。结论彩色多普勒超声可作为诊断和鉴别诊断腓肠肌血肿、小腿肌间静脉丛血栓首选和可靠的影像学方法,且对临床治疗有指导意义。Objective To study the value of color Doppler ultrasound in differential diagnosis of calf muscular venous thrombosis and calf haematoma. Methods The size, shape and sonographic characters of 24 cases with calf muscular venous thrombosis and 11 cases with calf haematoma were compared and analyzed retrospectively. Results The imaging of calf muscular venous thrombosis was hypoechoic which connected with veins on both sides, tubular or tree branches in longitudinal and round in transverse. There were sharp borderline with the muscles. More of them also had thrombosis in ipsilateral lower limb trunk veins. The imaging of calf haematoma was large lesions, with posterior enhancement and hyperechoic boundary, isoechoic or hypoechoic in the early age, then anoechoic areas increased. A part of the muscle fibers ruptured and occupied by the haematoma if the muscle tore. Conclusion Color Doppler ultrasound can be the first choice and reliable imaging method to distinguish the calf muscular venous thrombosis and calf haematoma. It is necessary to do ultrasound exam before anticoagulate.

关 键 词：超声检查 静脉血栓 小腿 血肿 

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