间接法CT静脉造影在诊断盆腔和下肢深静脉血栓中的价值  

Value of indirect computed tomography venography in diagnosis of pelvic and lower extremity deep venous thrombosis

作　　者：吴英宁[1] 韦勤将 柴梦琪 陈成彩 浦昌洪[1] 黄才明 WU Ying-ning;WEI Qin-jiang;CHAI Meng-qi;CHEN Cheng-cai;PU Chang-hong;HUANG Cai-ming(Radiology Department,Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,China;Cardiology Department,Affiliated Hospital,Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,China;Graduate School,Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,China;Ultrasound Department,Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,China;Interventional Department,Affiliated Hospital,Youjiang Medical University for Nationalities,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院放射科,广西百色市533000 [2]右江民族医学院附属医院心内科,广西百色市533000 [3]右江民族医学院研究生学院,广西百色市533000 [4]右江民族医学院附属医院超声科,广西百色市533000 [5]右江民族医学院附属医院,介入科,广西百色市533000

出　　处：《广西医学》2021年第4期434-437,共4页Guangxi Medical Journal

摘　　要：目的探讨间接法CT静脉造影(CTV)在诊断盆腔和下肢深静脉血栓(DVT)中的价值及其联合肺动脉CT血管成像(CTA)对盆腔和下肢DVT合并肺栓塞的诊断价值。方法回顾性分析105例经数字减影血管造影(DSA)确诊为盆腔和下肢DVT患者(661处血栓)的临床资料(所有患者均同时行超声和CTV检查,其中60例合并胸痛患者行肺动脉CTA联合CTV检查)。比较间接法CTV与超声诊断盆腔和下肢DVT的准确率及不同部位血栓的检出率,并分析间接法CTV联合肺动脉CTA对盆腔和下肢DVT患者合并肺栓塞的检出情况。结果超声检查诊断盆腔和下肢DVT正确率为93.3%(98/105),血栓检出率为64.6%(427/661);CTV检查诊断盆腔和下肢DVT正确率为97.1%(102/105),血栓检出率为89.6%(592/661)。CTV检查对髂总静脉、髂内静脉、髂外静脉、胫前静脉、腓静脉血栓的检出率优于超声检查,而超声检查对股深静脉、胫后静脉血栓的检出率优于CTV检查(均P<0.05)。60例胸痛患者行肺动脉CTA联合下肢CTV扫描,诊断为肺栓塞25例。结论间接法CTV诊断盆腔和下肢DVT的准确率较高,尤其对盆腔DVT及胫前、腓静脉血栓的检出率更高,可作为诊断下肢DVT的补充检查以弥补超声检查的不足,且其联合肺动脉CTA对及时发现DVT合并肺栓塞也具有重要的意义。Objective To explore the value of indirect computed tomography venography(CTV)in diagnosing pelvic and lower extremity deep venous thrombosis(DVT),as well as the diagnostic value of its combination with pulmonary artery computed tomography angiography(CTA)for pelvic and lower extremity DVT complicated with pulmonary embolism.Methods The clinical data of 105 patients with pelvic and low extremity DVT confirmed by digital subtraction angiography(DSA)were analyzed retrospectively.All patients underwent ultrasound and CTV examinations simultaneously,including 60 cases of concomitant chest pain undergoing pulmonary artery CTA combined with CTV examinations.Indirect CTV was compared with ultrasound in terms of the diagnostic accuracy rate for pelvic and lower extremity DVT and the detection rate for thrombus at different parts.In addition,the detection findings of indirect CTV combined with pulmonary artery CTA were analyzed in patients with pelvic and lower extremity DVT complicated with pulmonary embolism.Results Ultrasound examination yielded a diagnostic accuracy rate of 93.3%(98/105)for pelvic and lower extremity DTV,and a detection rate of 64.6%(427/661)for thrombus;CTV examination yielded a diagnostic accuracy rate of 97.1%(102/105)for pelvic and lower extremity DTV,and a detection rate of 89.6%(592/661)for thrombus.CTV examination was superior to ultrasound examination in the detection rates for common iliac vein,internal iliac vein,external iliac vein,anterior tibial vein and fibular vein thrombi,whereas ultrasound examination had better detection rates for deep femoral vein and posterior tibial vein thrombi than CTV examination(all P<0.05).Of 60 chest pain cases undergoing pulmonary artery CTA combined with lower extremity CTV scanning,25 were diagnosed with pulmonary embolism.Conclusion Indirect CTV has a relatively high diagnostic accuracy rate for pelvic and lower extremity DVT,especially for pelvic DVT,anterior tibial vein and fibular vein thrombi,and can act as a supplement to the examination for lower e

关 键 词：深静脉血栓 下肢 盆腔 肺栓塞 计算机体层成像 静脉造影 超声检查 

分 类 号：R445.3[医药卫生—影像医学与核医学] R654.4[医药卫生—诊断学]