彩色多普勒血流成像对单侧不同范围下肢深静脉血栓周围软组织改变的诊断价值  

Value of color Doppler ultrasound in diagnosis of changes of soft tissues around deep venous thrombosis in unilateral lower extremity

作　　者：胡小涛[1] 魏然[1] 曲文洲 樊瑜[1] 陈寅[1] 樊珺[1] 

机构地区：[1]上海市中西医结合医院超声诊断科,上海200082

出　　处：《肿瘤影像学》2015年第3期222-225,共4页Oncoradiology

摘　　要：目的:探讨彩色多普勒血流成像(CDFI)对单侧不同范围下肢深静脉血栓周围软组织改变的诊断价值。方法:选取80例单侧下肢水肿患者,均为单侧下肢深静脉血栓形成。按血栓累及血管范围分为3级:Ⅰ级(累及1根深静脉,46例)、Ⅱ级(累及2根深静脉,26例)、Ⅲ级(累及3根及以上深静脉,8例)。观察各级深静脉血栓CDFI表现及邻近肌层、皮下组织的超声表现,并与同一患者健肢对比,测量患肢皮下组织增厚度、肌层增厚度、肌层回声改变及肌层组织形态改变等指标。结果:深静脉血栓表现为静脉管腔内可见不均匀低回声及中等回声,CDFI不能探及血流信号,或仅有少许点线状血流;静脉邻近肌层厚度较健侧增厚,其中Ⅲ级与Ⅰ级比较肌层增厚度差异有统计学意义(t=2.161,P<0.05);肌层组织回声较健侧减低或增高;患肢肌层间隙可见裂隙样或片状无回声,且血栓累及范围越广(达Ⅲ级),上述征象越明显(χ2=20.033,P<0.05)。结论:下肢深静脉血栓形成的范围与邻近软组织超声表现相关。CDFI不但能直观显示下肢深静脉血栓,而且能观察血管周围肌层及皮下组织情况,是临床下肢水肿患者的首选辅助检查方法。Objective: To explore the value of color Doppler ultrasound in diagnosis of changes of soft tissues around deep venous thrombosis in unilateral lower extremity. Methods: A total of 80 cases with unilateral lower extremity edema were chosen. They all had deep venous thrombosis. According to thrombosis staging, the cases were divided into stage Ⅰgroup(one vein involved, n=46), stage Ⅱ group(two veins involved, n=26) and stage Ⅲ group(more than two veins involved, n=8). The color Doppler flow imaging(CDFI) features of thrombosis and the adjacent muscles and subcutaneous tissues were observed. Compared with the healthy lower extremity, the muscle thickness, the subcutaneous tissue thickness and the changes of structure and echo of the ill lower extremity were measured. Results: Deep venous thrombosis displayed low or medium echo. CDFI can not detect the blood flow signal or only little flow could be seen in the veins. The muscles were thickened and there was difference between stage Ⅲ and stage Ⅰgroups(t=2.161, P<0.05). Compared with the healthy lower extremity, the muscle echo of illed lower extremity was higher or lower than that of healthy lower extremity. Fissure or patchy anecho between muscles could be seen in some patients, and the features were more obvious with increased thrombosis(χ2=20.033, P<0.05). Conclusion: The ultrasonogram of soft tissues around deep venous thrombosis is closely correlated to thrombosis stage. Not only the deep venous thrombosis can be shown directly by color Doppler, but also the changes of adjacent muscles and subcutaneous tissues can be displayed. Color Doppler is the preferred auxiliary examination method for low extremity edema patients.

关 键 词：彩色多普勒血流成像 深静脉血栓 软组织 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]