彩色多普勒超声与CT静脉造影诊断左髂静脉压迫综合征的临床价值  

Value of color Doppler ultrasound and CT venography in the diagnosis of left iliac vein compression syndrome

作　　者：薄飞[1] 刘大伟[2] 许宏伟[3] 白夜 马文灿 BO Fei;LIU Dawei;XU Hongwei;BAI Ye;MA Wencan(Department of Ultrasound Diagnosis,Chengde Central Hospital,Chengde,Hebei Province 067000,China;Department of Interventional Vascular Surgery,Chengde Central Hospital,Chengde,Hebei Province 067000,China;Department of Radiology,Chengde Central Hospital,Chengde,Hebei Province 067000,China;Catheter Room,Chengde Central Hospital,Chengde,Hebei Province 067000,China)

机构地区：[1]承德市中心医院超声诊断科,河北承德067000 [2]承德市中心医院介入血管外科,河北承德067000 [3]承德市中心医院放射科,河北承德067000 [4]承德市中心医院导管室,河北承德067000

出　　处：《实用放射学杂志》2022年第2期227-231,共5页Journal of Practical Radiology

摘　　要：目的探讨彩色多普勒超声(CDUS)与CT静脉造影(CTV)在左髂静脉压迫综合征(IVCS)诊断中的临床价值.方法以79例左侧静脉曲张患者为研究对象,通过对下肢静脉行数字减影血管造影(DSA),诊断结果分为左IVCS组27例、无IVCS组52例.所有患者均经CDUS或CTV检查,通过比较2组CDUS和CTV检查指标,分析CDUS、CTV或两者联合对左IVCS的诊断性能.采用受试者工作特征(ROC)曲线分析CDUS与CTV对IVCS的诊断价值.结果CDUS诊断左IVCS准确度83.5%,CTV诊断左IVCS准确度87.3%,CDUS联合CTV诊断左IVCS准确度89.9%;无IVCS组患者CDUS左髂静脉前后径明显高于左IVCS组(P<0.05),无IVCS组患者血流速度、压力梯度明显低于左IVCS组(P<0.05);无IVCS组患者CTV左髂静脉前后径明显高于左IVCS组(P<0.05);经ROC曲线分析,CDUS诊断左IVCS的曲线下面积(AUC)为0.840,特异度88.5%,灵敏度74.1%;CTV诊断左IVCS的AUC为0.906,特异度90.4%,灵敏度81.5%;CDUS联合CTV诊断左IVCS的AUC为0.936,特异度86.5%,灵敏度96.3%.结论CDUS联合CTV在左IVCS的诊断中具有较高准确度和灵敏度,可为左IVCS的早期诊疗提供重要依据.Objective To evaluate the diagnostic value of color Doppler ultrasound(CDUS)and computed tomography venography(CTV)for left iliac vein compression syndrome(IVCS).Methods A total of 79 patients with left varicose veins treated were collected as research obj ects.According to the results of digital subtraction angiography(DSA)of lower extremity vein,27 subj ects were divided into the left IVCS group,and 52 subj ects were divided into the non-IVCS group.Each of the patients was examined by CDUS or CTV.Further,the subj ects were respectively diagnosed by the way of CDUS,CTV or the combination of CDUS and CTV.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of CDUS and CTV for IVCS.Results The diagnostic accuracy for left IVCS were respectively 83.5%,87.3%,89.9%in the way of CDUS,CTV and CDUS combined with CTV.The left iliac vein anteroposterior diameter of CDUS in the non-IVCS group were significantly higher than those in the left IVCS group(P<0.05),the blood flow velocity and pressure gradient in the non-IVCS group were significantly lower than those in the left IVCS group(P<0.05),the left iliac vein anteroposterior diameter of CTV in the non-IVCS group was significantly higher than that in the left IVCS group(P<0.05).The result of ROC curve analysis showed that the area under the curve(AUC)of CDUS for the diagnosis of left IVCS was 0.840,the specificity was 88.5%,and the sensitivity was 74.1%;the AUC of CTV for the diagnosis of left IVCS was 0.906,the specificity was 90.4%,and the sensitivity was 81.5%;the AUC of CDUS combined with CTV for the diagnosis of left IVCS was 0.936,the specificity was 86.5%,and the sensitivity was 96.3%.Conclusion CDUS combined with CTV has high diagnostic accuracy and sensitivity of left IVCS,which can provide an important basis for the early diagnosis and treatment.

关 键 词：彩色多普勒超声 CT静脉造影 左髂静脉压迫综合征 

分 类 号：R445.1[医药卫生—影像医学与核医学] R814.43[医药卫生—诊断学]