布加综合征合并下腔静脉血栓形成的彩色多普勒超声诊断  

作　　者：仇焕[1] 徐浩[1] 徐新建[1] 王兴田[2] 崔建华[2] 

机构地区：[1]江苏省徐州市徐州医学院附属医院介入放射科,江苏221006 [2]江苏省徐州市徐州医学院附属医院超声科

出　　处：《当代医学》2013年第19期5-7,共3页Contemporary Medicine

摘　　要：目的探讨彩色多普勒超声(CDUS)在布加综合征(BCS)合并下腔静脉(IVC)血栓形成的诊断与临床应用价值。方法回顾性分析江苏省徐州市徐州医学院附属医院介入放射科2009年5月-2012年7月36例诊断为BCS合并IVC血栓形成患者的临床资料,患者均于入院1周内行CDUS检查、数字减影血管造影(DSA)检查及IVC置管溶栓治疗。溶栓时长2～20d。研究对象据入组标准共25例患者入组。收集其术前CDUS检查及术中DSA检查结果,并进行统计学分析。结果急性血栓共13例,慢性血栓共12例。急性血栓在超声上多为低回声(8/13),慢性血栓在超声上多为高回声或等回声(10/12)。另外,比较急性血栓与慢性血栓患者的超声检查结果发现:急性血栓多为中心性腔内充盈缺损(12/13),而慢性血栓多为偏心性腔内充盈缺损,即附壁血栓(6/12),差异有统计学意义(P=0.03)。超声对急性血栓诊断灵敏度为61.5%,特异度为83.3%,阳性预测值80.0%,阴性预测值66.7%。CDUS显示IVC血栓的长度范围(62±26)mm,与DSA显示的IVC血栓的长度范围(83±40)mm相比较,差异有统计学意义(P=0.026),而CDUS显示IVC血栓的直径范围(20±10)mm,与DSA显示的IVC血栓的直径范围(24±8)mm相比较,差异无统计学意义(P=0.412)。结论 CDUS对IVC的闭塞程度、血栓的形态、范围、新旧程度等病变特征可进行比较理想的描述及评估,灵敏度和特异度较高,虽然单项超声检查有一定局限性,但CDUS对IVC血栓的诊断及急慢性程度判别方面具有重要的临床参考价值。Objective To assess the values of color Doppler ultrasound in detection of budd-chiari syndrome（BCS） with inferior vena cava （ IVC） thrombosis.Methods A total of 36 patients diagnosed as BCS with IVC thrombosis during the period of May 2009 to July 2012 in the department of interventional radiology in our hospital were selected,and the clinical data were retrospectively analyzed. All patients underwent CDUS,digital subtraction angiography （DSA） inspection and transcather thrombolytic therapy within 1 week after admitted to hospital. The study inclusion criteria：The patients with the thrombosis complete disappearance were defined as acute IVC thrombosis group;The patients without any resolution of the thrombosis were defined as chronic IVC thrombosis group;The patients with the thrombosis partial resolution were removed from the group. A total of 25 patients were involved in this study.The CDUS and DSA results for statistical analysis were collected.Results In all cases, 13 cases were acute IVC thrombosis,8 cases were chronic IVC thrombosis,In CDUS, acute IVC thrombosis were of low-echo density （8/13）, chronic IVC thrombosis were of moderate- to high-echo density （10/12）.In addition we found that in CDUS：the acute thrombi were more often central intraluminal filling defect than the chronic thrombi （12/13 vs 6/12） , P=0.03.The corresponding sensitivity of CDU was 61.5%;the specificity was 83.3%,80.0%;The positive predictive value was 80%;The negitive predictive value was 66.7%.Compare with CDUS and DSA,There was significant difference in the length of IVC thrombosis display （ 83± 40） mm vs （62 ± 26） mm, P=0.026;While there was no significant differencein the display of the IVC thrombosis diameter（24 ± 8） mm vs （20 ± 10） mm） （P=0.412）.Conclusion CDU can describe the degree of occlusion,the shape and extent of the thrombus,the degree of fresh or stale and so on with a high sensitivity and specificity.Although the individual ultrasound has some limitations, CDU exa

关 键 词：下腔静脉 血栓 彩色多普勒超声 血管造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]