髋膝关节术后顺行性下肢深静脉造影误诊原因分析  

Misdiagnosis causes analysis for ascending deep venography of lower limb after hip and knee surgery

作　　者：杨献峰[1] 顾康康[1] 张祯[1] 姚尧[2] 戎朕 朱斌[1] 蒋青[2] 

机构地区：[1]南京大学医学院附属鼓楼医院放射科,南京210008 [2]南京大学医学院附属鼓楼医院骨科,南京210008

出　　处：《医疗卫生装备》2014年第12期67-69,共3页Chinese Medical Equipment Journal

基　　金：国家自然科学基金项目(30973046)

摘　　要：目的:分析髋、膝关节术后顺行性下肢深静脉血管造影误诊的原因,提高对下肢深静脉血栓造影的认识。方法:回顾分析医院2012年9月到2013年4月195例下肢深静脉造影图像,对误诊原因进行分析及归类。结果:195例患者中,发生误诊9例,误诊率为4.6%。3名观察者累计误诊18例次,其中假阳性占61.1%(11/18),假阴性占38.9%(7/18);中心型误诊占1.1%(2/18),周围型误诊占98.9%(16/18)。误诊原因中,技术因素占66.7%(12/18),观察者占因素33.3%(6/18)。结论:多种因素可导致下肢深静脉造影误诊,通过规范造影流程、加强对静脉解剖及病变的认识可减少对下肢深静脉血栓的误诊。Objective To analyze the misdiagnosis causes for ascending deep venography of lower limb after hip and knee surgery. Methods Totally 195 patients undergoing deep venography of lower limb from September 2012 to April 2013 had their images reviewed retrospectively, and the misdiagnosis causes were analyzed and classified. Results A total of 19 ones were misdiagnosed with the rate of 4.6%. There were 3 ones misdiagnosed for 18 times, of which, false positive results accounted for 61.1%（11/18）, false negative ones for 38.9%（7/18）, central type for 1.1%（2/18）, peripheral type for98.9%（16/18）, technical misdiagnosis for 66.7%（12/18） and observer misdiagnosis for 33.3%（6/18）. Conclusion Multiple factors may result in misdiagnosis of deep vein thrombosis by venography. Standardization of examination procedure and improvement of awareness of vein anatomy and pathology can help reduce the misdiagnosis of deep vein thrombosis.

关 键 词：下肢深静脉 静脉造影 血栓 误诊 

分 类 号：R687.4[医药卫生—骨科学]