声触诊弹性成像对继发性下肢深静脉血栓临床分期的相关研究  

The staging of secondary deep venous thrombosis of lower extremities by sound touch elastography

作　　者：郭长旭 袁宇[1] 高金妹[1] 魏瑶 GUO Changxu;YUAN Yu;GAO Jinmei;WEI Yao(Department of Ultrosound,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院超声科,天津300211

出　　处：《国际医学放射学杂志》2022年第6期649-653,共5页International Journal of Medical Radiology

摘　　要：目的利用声触诊弹性成像(STE)技术定量测量骨折继发下肢深静脉血栓(DVT)弹性模量值,探讨血栓弹性模量值与临床分期的关系。方法纳入骨折后48 h内经常规超声确诊股静脉或腘静脉血栓的病人78例[平均年龄(55.7±14.3)岁],利用STE技术进行弹性模量值随访测量,每例病人均选取股静脉或腘静脉中的1处血栓进行STE弹性模量值的随访测量,病人栓塞后管腔完全再通或血栓短径缩小至3 mm以下则停止随访。共测得144个弹性模量值,根据血栓所处时间将数据分为4组,急性1组(1~7 d)51个、急性2组(8~14 d)36个、亚急性组(15~30 d)33个、慢性组(31~180 d)24个。如急性1组和急性2组弹性模量值差异无统计学意义,将2组合并为急性期DVT组进一步分析。对4组弹性模量值单因素方差分析,组间两两比较采用Tamhane’s T2检验。采用受试者操作特征(ROC)曲线下面积(AUC)评估血栓弹性模量值对血栓分期的诊断效能。结果急性1组、急性2组、亚急性组和慢性组血栓的平均弹性模量值分别为(10.15±1.73)、(11.04±1.86)、(13.69±3.06)、(18.45±4.16)kPa。其中急性1组和急性2组弹性模量值差异无统计学意义(P>0.05)。急性组(1组和2组)、亚急性组和慢性组平均弹性模量值呈依次递增趋势(均P<0.05)。弹性模量值13.19 kPa时鉴别血栓急性期和亚急性期的AUC更大(0.806),敏感度和特异度分别为93.1%、63.6%。弹性模量值17.23 kPa时鉴别亚急性期和慢性期的AUC更大(0.828),敏感度和特异度分别为90.9%、66.7%。结论深静脉血栓的弹性模量值随时间延长而增加,STE技术对评估DVT临床分期有指导意义。Objective To quantitatively measure the thrombus elasticity of deep venous thrombosis(DVT)of lower extremities secondary to fracture by sound touch elastography(STE),and explore the relationship between thrombus elasticity and clinical stage.Methods A total of 78 patients(mean age 55.7±14.3 years)with femoral vein or popliteal vein thrombosis diagnosed by conventional ultrasound within 48 hours after fracture were enrolled.STE was used to measure the follow-up elastic modulus from a thrombus in femoral vein or popliteal vein,follow-up is discontinued if the lumen is completely recanalized after thrombosis or if the short menstrual period of the thrombus is reduced to less than 3 mm.A total of 144 elastic modulus values were measured,and the data were divided into 4 groups according to the time of thrombosis,including 51 acute group(1-7 d),36 acute group(8-14 d),33 subacute group(15-30 d),and 24 chronic group(31-180 d).If there was no significant difference in elastic modulus value between acute 1 group and acute 2 groups,the 2 groups were combined as acute DVT group for further analysis.For the one-way ANOVA analysis of elastic modulus values of four groups,Tamhane’s T2 test was used for post-hoc comparisons.The receiver operating characteristics(ROC)curve(AUC)was used to evaluate the diagnostic power of thrombus elastic modulus for thrombosis staging.Results The mean elastic modulus of thrombosis in the acute 1,2,subacute,and chronic groups were 10.15±1.73,11.04±1.86,13.69±3.06,and 18.45±4.16 kPa,respectively.There was no significant difference in elastic modulus between the acute 1 group and acute 2 groups(P>0.05).The average elastic modulus of acute group(1 and 2 groups),subacute group and chronic group increased sequentially(all P<0.05).When the elastic modulus was 13.19 kPa,the AUC in differentiating acute and subacute thrombosis was highest(0.806),and the sensitivity and specificity were 93.1%and 63.6%,respectively.When the elastic modulus value was 17.23 kPa,the AUC in differentiating subacute and c

关 键 词：继发下肢深静脉血栓 声触诊弹性成像 血栓分期 彩色多普勒 

分 类 号：R604[医药卫生—外科学] R445.1[医药卫生—临床医学]