下肢静脉常规超声检查联合CT血管造影技术在缺血性脑卒中后下肢深静脉血栓形成评估中的研究  

Research of routine ultrasound examination combined with CTV angiography for lower extremity veins in assessing deep venous thrombosis of lower extremity after ischemic stroke

作　　者：刘天鹰 段欣 张改 王文利[2] Liu Tianying;Duan Xin;Zhang Gai;Wang Wenli(Department of Ultrasound,Xidian Group Hospital,Xi'an 710077,China;Department of Ultrasound,Xi'an No.3 Hospital,The Affiliated Hospital of Northwest University,Xi'an 710018,China)

机构地区：[1]西电集团医院超声科,西安710077 [2]西北大学附属医院西安市第三医院超声科,西安710018

出　　处：《中国医学装备》2025年第3期63-67,共5页China Medical Equipment

基　　金：陕西省重点研发计划项目(2022SF-397)。

摘　　要：目的:分析下肢静脉常规超声检查联合CT静脉血管造影(CTV)在缺血性脑卒中后下肢深静脉血栓(DVT)形成评估中的效果。方法:回顾性分析2020年1月至2023年5月西电集团医院进行治疗的132例缺血性脑卒中患者的临床资料,所选患者均疑似下肢DVT形成,故接受数字减影血管造影(DSA)、下肢静脉常规超声和CTV检查,以DSA检查结果为“金标准”,分析下肢静脉常规超声检查联合CTV在脑卒中后下肢DVT形成中的诊断效能。结果:经DSA检查结果证实,132例疑似下肢DVT形成患者中,共计128例患者确诊下肢DVT;下肢静脉常规超声检出下肢DVT形成102例,超声诊断结果与DSA一致性一般(Kappa=0.461,P=0.000);CTV检出111例下肢DVT形成,CTV诊断结果与DSA一致性一般(Kappa=0.605,P=0.000);下肢静脉常规超声联合CTV诊断下肢DVT形成结果与DSA一致性较好(Kappa=0.752,P=0.000);超声联合CTV诊断准确率、灵敏度和阴性预测值分别为93.33%、94.53%和73.08%,均明显高于单项诊断,差异均有统计学意义(x^(2)=10.727、12.463、6.313,P<0.05)。结论:下肢静脉常规超声检查联合CTV诊断缺血性脑卒中后的下肢DVT形成,能够提高临床诊断准确率和诊断效能,有助于患者病情的评估。Objective:To analyze the effect of routine ultrasound examination combined with computed tomography venous(CTV)angiography for lower extremity veins in assessing deep vein thrombosis(DVT)of lower extremity after ischemic stroke.Methods:The clinical data of 132 patients with ischemic stroke,who admitted to XiDian Group Hospital from January 2020 to May 2023,were retrospectively analyzed.All selected patients were suspected as DVT in lower extremity,so they underwent digital subtraction angiography(DSA),routine ultrasound and CTV examination for lower extremity veins.The result of DSA examination was used as the gold standard.The diagnostic efficacy of routine ultrasound examination combined with CTV for the DVT of lower extremity after stroke was further analyzed.Results:The results of DSA examination confirmed that a total of 128 cases of 132 patients with suspected DVT were diagnosed as DVT in lower extremity.The routine ultrasound on lower extremity found out about 102 cases with DVT on lower extremity,and the consistency between the results of ultrasound diagnosis and the results of DSA diagnosis was general(Kappa=0.461,P=0.000).The CTV found out about 111 cases with DVT on lower extremity,and the consistency between the results of CTV diagnosis and the results of DSA diagnosis also was general(Kappa=0.605,P=0.000).The diagnostic result of the combination of routine ultrasound and CTV for DVT in lower extremity had better consistency with DSA result(Kappa=0.752,P=0.000).The diagnostic accuracy(93.33%),sensitivity(94.53%)and negative predictive value(73.08%)of ultrasound combined with CTV were significantly higher than those of single diagnosis,and the differences of them were statistically significant(x^(2)=10.727,12.463,6.313,P<0.05).Conclusion:The diagnosis of the routine ultrasound examination combined with CTV for DVT of lower extremity after ischemic stroke can improve the accuracy and diagnostic efficacy of clinical diagnosis,which is contribute to the assessment of patients'disease conditions.

关 键 词：下肢深静脉血栓(DVT) 下肢静脉超声 CT血管造影 缺血性脑卒中 

分 类 号：R816.1[医药卫生—放射医学] R445.1[医药卫生—临床医学]