彩色多普勒超声在小腿肌间静脉血栓诊断中的临床应用价值  

Study on clinical significance of color Doppler sonography in diagnosis of thrombosis in muscular calf vein

作　　者：江波[1] 钱林学[1] 马棣[1] 胡向东[1] 

机构地区：[1]首都医科大学附属北京友谊医院超声医学科,北京100050

出　　处：《临床和实验医学杂志》2018年第3期330-332,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨彩色多普勒超声在诊断小腿肌间静脉血栓及评估临床溶栓效果中应用的价值。方法回顾性分析2016年7月至2017年7月临床确诊为小腿肌间静脉血栓并进行溶栓治疗的患者221例,分析肌间静脉血栓的超声特点,并于溶栓治疗前、后超声随访肌间静脉管腔管壁情况、管腔血流情况、管腔血栓回声强度变化情况等,总结超声诊断的准确率、漏诊率、误诊率以及超声随访临床溶栓治疗的效果。结果临床确诊小腿肌间静脉血栓共221例,超声诊断共206例,诊断准确率为93.2%(206/221),漏诊10例(漏诊率4.5%,10/221),误诊5例(误诊率2.3%,5/221)。治疗1周后彩超复查,155例血栓完全再通,66例部分再通;1个月后复查,199例完全再通,22例部分再通;3个月后复查,22例部分再通中有15例演变为陈旧性血栓。结论彩色多普勒超声对小腿肌间静脉血栓具有很高的诊断率,是动态评估临床溶栓效果的首选影像检查工具。Objective The purpose of this paper is to explore the signficance of color Doppler ultrasonography in diagnosis of muscular calf vein thrombosis(MCVT) and to evaluate the clinical effect of thrombolysis.Methods The clinical data of 221 patients with MCVT underwent thrombolytic therapy in this hospital during July 2016 to July 2017 were retrospectively analyzed.The ultrasonographic features of MCVT were analyzed,and the condition of vascular cavity wall of intermuscular vein had been recorded before treatment and followed-up after thrombolytic therapy,and the condition of blood flow in vascular cavity,the changes in echo intensity of the thrombosed cavity etc.The accuracy rate,diagnostic rate,misdiagnostic rate and evaluation of the effectiveness of clinical thrombolytic therapy were summarized.Results In this hospital,221 cases of MCVT were diagnosed and 206 of them were diagnosed by ultrasonography.The rate of diagnostic accuracy was 93.2%(206/221),10 cases were missed diagnosis(4.5%,10/221),and 5 cases were misdiagnosed(misdiagnostic rate was 2.3%,5/221).After treatment for 1 week,the color Doppler ultrasound examination was performed,and the thrombotic vassels had been completely reconnected in 155 cases and partially reconnected in 66 cases.After follow-up for 1 month,199 cases were completely reconnected and 22 cases were partially reconnected.After follow-up for 3 months,15 of 22 patients were rechecked,and 15 of them developed into old thrombus.Conclusion Color Doppler ultrasonography has a high diagnostic rate and it is the first choice for imaging tool in evaluating clinical efficacy of thromlytiic treatment for MCVT.

关 键 词：小腿肌间静脉血栓形成 彩色多普勒超声 诊断 溶栓治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]