超声弹性成像、血浆D-D在LEDVT形成部位及分期的联合预测价值  

Study on joint prediction of formation site and stage of LEDVT by ultrasound elastography and serum D-D

作　　者：翟菲菲 田径[1,2] 田澍辉 吴梅 刘斌[1,2] ZHAI Feifei;TIAN Jing;TIAN Shuhui;WU Mei;LIU Bin(Department of Interventional Medicine,Minimally Invasive Oncology,The Second Hospital of Shandong University,Jinan 250033,China;The Institute of Interventional Oncology,Shandong University,Jinan 250033,China;Department of Ultrasound Medicine,Shandong University Qilu Hospital Dezhou Hospital,Dezhou 253000,China;Department of Ultrasound,The Second Hospital of Shandong University,Jinan 250033,China)

机构地区：[1]山东大学第二医院介入与肿瘤微创治疗科,山东济南250033 [2]山东大学肿瘤介入学研究所,山东济南250033 [3]山东大学齐鲁医院德州医院超声科,山东德州253000 [4]山东大学第二医院超声科,山东济南250033

出　　处：《医学影像学杂志》2025年第1期126-130,共5页Journal of Medical Imaging

摘　　要：目的探讨超声弹性成像参数、血浆D-二聚体(D-D)与下肢深静脉血栓(LEDVT)形成部位的关系,分析其对LEDVT分期的联合预测价值。方法选取我院收治的160例LEDVT患者,根据不同形成部位分为股静脉血栓组(n=52)、腘静脉血栓组(n=60)、肌间静脉血栓组(n=48);根据不同分期划分为急性期组(n=89)与亚急性期组(n=71)。比较不同部位患者超声弹性成像参数、血浆D-D水平差异。采用二元Logistic回归分析急性期LEDVT的影响因素,建立风险预测模型并予以验证。结果不同部位LEDVT患者二维超声评分、应变式弹性评分、杨氏模量均值(E_(mean))比较差异有统计学意义(P<0.05),股静脉血栓组二维超声评分、应变式弹性评分、E_(mean)相对更低,血浆D-D水平相对更高,急性期差异更为显著。急性期组与亚急性期组二维超声评分、应变式弹性评分、E_(mean)、血浆D-D比较差异有统计学意义(P<0.05)。多因素分析显示高二维超声评分、高应变式弹性评分、高E_(mean)为急性期LEDVT的保护因素(P<0.05),血浆D-D水平增加为急性期LEDVT的独立危险因素(P<0.05)。构建的列线图模型对急性期LEDVT的曲线下面积(AUC)为0.976(95%CI:0.957~0.995)。内部验证发现该模型有良好稳定性且有正向净收益率。结论不同部位LEDVT超声弹性成像参数、血浆D-D水平存在差异,急性期更为显著;基于二维超声评分、应变式弹性评分、E_(mean)、血浆D-D建立的列线图模型对急性期LEDVT有良好预测价值,可为临床诊疗提供有力支持。Objective To investigate the relationship between ultrasound elastic imaging parameters,plasma D-dimer(DD)and the formation site of lower extremity deep vein thrombosis(LEDVT),and to analyze its value in predicting the stage of LEDVT.Methods 160 LEDVT patients in our hospital were selected and divided into femoral vein thrombosis group(n=52),popliteal vein thrombosis group(n=60),and intermuscular vein thrombosis group(n=48)according to different formation sites.They were divided into acute stage group(n=89)and subacute stage group(n=71).The differences of ultrasound elastic imaging parameters and serum D-D levels were compared in different parts of patients.Binary Logistic regression was used to analyze the influencing factors of LEDVT in acute stage,and the risk prediction model was established and verified.Results The twodimensional ultrasound score,strain-gauge elasticity score and mean value of Young's modulus of LEDVT patients at different sites were compared(P<0.05).The two-dimensional ultrasound score,strain-gauge elasticity score and mean value of Young's modulus of LEDVT patients in femoral vein thrombosis group were relatively lower,the serum D-D level was relatively higher,and the difference was more significant in acute stage.Two dimensional ultrasound score,strain gauge elasticity score,mean Young's modulus and serum D-D were compared between acute stage group and subacute stage group(P<0.05).Multivariate analysis showed that high two-dimensional ultrasound score,high strain elastic score and high mean Young modulus were protective factors for LEDVT in acute stage(P<0.05),and increased serum D-D level was an independent risk factor for LEDVT in acute stage(P<0.05).The curve AUC for LEDVT in acute stage was 0.976(95%CI:0.957-0.995).Internal verification showed that the model had good stability and positive net return.Conclusion LEDVT ultrasound elastography parameters and serum DD levels are different in different parts,especially in the acute phase.The nomogram model based on two-dimensional ultrasou

关 键 词：下肢静脉血栓 超声弹性成像 血浆D-二聚体 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]