彩超和血流检查诊断下肢深静脉血栓的对比研究

Comparison of color Doppler ultrasonogarphy and Doppler ultrasound for the diagnosis of lower extremity deep venous thrombosis

目的评估彩色多普勒超声（以下简称：彩超）及多普勒超声血流检查（以下简称：血流检查）在下肢深静脉血栓方面的诊断价值。方法对84例患者（包括下肢深静脉血栓形成、深静脉血栓后遗症及原发性下肢静脉瓣膜功能不全的患者）共92侧下肢分别进行深静脉的彩超及血流检查，并与下肢深静脉造影（做为“金标准”）做比较。结果与下肢深静脉造影对比，彩超的准确率、敏感性、特异性、漏诊率、误诊率、约登指数、比数积、阳性预测值、阴性预测值及Kappa值分别为96．7％、95．7％、97．8％、4．3％、2．2％、0．935、990．0、97．8％、95．7％及0．935（P=0．037）。由于彩超的Kappa值（0．935）〉0．75，且P（0．037）〈0．05，故理论上彩超可以替代下肢深静脉造影检查；血流检查的以上指标分别为89．1％、87．2％、91．1％、12．8％、8．9％、0．783、70．0、91．1％、87．2％及0．783（P=0．065）。结论彩超可以作为确诊下肢深静脉血栓首选的更可靠的无创伤检查方法。

Objective To evaluate the diagnostic role of color Doppler ultrasonogarphy（ CDU）, Doppler ultrasound （DU） in the diagnosis of lower extremity deep venous thrombosis （DVT）. Methods In this study, 84 patients （92 lower extremities） of lower extremity DVT were underwent CDU and DU and lower extremity deep venous angiography respectively. Results Total consistent rate, sensitivity, specificity, omission diagnostic rate, mistake diagnostic rate, Youden index, Odd product, positive predictive value, negative predictive value and Kappa of CDU in diagnosing lower extremity DVT was respectively 96.7%, 95.7%, 97. 8%, 4. 3%, 2.2%, 0. 935, 990. 0, 97.8%, 95.7% and 0. 935 （ P = 0. 037）. As Kappa of CDU（0. 935） 〉0.75 and its P（0. 037） 〈0.05, CDU can theoretically substitute for deep venous angiography; Above-mentioned indexes of DU were respectively 89. 1%, 87.2%, 91.1%, 12.8% ,8.9% ,0.783,70.0,91.1% ,87.2% and 0.783（P =0.065）. Conclusion CDU is becoming preferred and more reliable noninvasive method in diagnosing lower extremity DVT.