血管腔内超声与静脉造影在髂静脉压迫综合征术中诊断价值的比较  

Comparison of intravascular ultrasound and venography in the intraoperative evaluation of iliac vein compression syndrome

作　　者：丁勇 赵格非 周旻 蔡亮 王利新 唐骁 郭大乔 史振宇 Ding Yong;Zhao Gefei;Zhou Min;Cai Liang;Wang Lixin;Tang Xiao;Guo Daqiao;Shi Zhenyu(Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院血管外科,上海200032

出　　处：《中华普通外科杂志》2019年第9期753-756,共4页Chinese Journal of General Surgery

摘　　要：目的评估血管腔内超声和静脉造影在髂静脉压迫综合征术中的诊断价值。方法前瞻性对2017年9月至2018年3月我科诊治的髂静脉压迫综合征患者同时行血管腔内超声和静脉造影检查,比较两者测量的狭窄程度和管腔偏心性。结果总计纳入40例患者(48条患肢)。相比于血管腔内超声,静脉造影低估了髂静脉压迫综合征患者的直径狭窄率(39.63%±15.48%比64.97%±16.42%,P<0.001)和面积狭窄率(51.83%±18.23%比59.19%±14.17%,P=0.021),且静脉造影下测量的管腔偏心性显著低于血管腔内超声下测量的偏心性(0.69±0.17比0.93±0.17,P<0.001)。以血管腔内超声为金标准,静脉造影发现髂静脉显著性狭窄病变的敏感性为18.92%,特异性为81.82%,两者的诊断一致性极低(κ=0.004)。结论相比于血管腔内超声,静脉造影显著低估了髂静脉压迫综合征的狭窄程度。静脉造影发现髂静脉显著性狭窄的敏感性低。Objective To compare intravascular ultrasound(IVUS)with venography in the intraoperative evaluation of iliac vein compression syndrome(IVCS).Methods From Sep 2017 to Mar 2018,consecutive patients with suspicious iliac vein compression,underwent both venography and IVUS.The results were compared between IVUS and venography.Results 40 patients with 48 limbs were enrolled.Venography underestimated both the diameter and area stenosis compared with IVUS(39.63%±15.48%vs.64.97%±16.42%,P<0.001;51.83%±18.23%vs.59.19%±14.17%,P=0.021,respectively).The eccentricity detected by venography was lower than IVUS(0.69±0.17 vs.0.93±0.17,P< 0.001).Taking IVUS as gold standard,the sensitivity and the specificity of venography for detecting a M50%stenosis was 1&92%and 81.82%,and the intertechnique agreement was extremely low between venography and IVUS(κ=0.004).Conclusion Compared with IVUS,venography underestimated the degree of stenosis in IVCS.The sensitivity of venography in detecting a significant stenosis was very low.

关 键 词：超声检查 介入性 静脉造影术 髂静脉压迫综合征 

分 类 号：R47[医药卫生—护理学]