超声在下肢穿静脉功能不全中的诊断与定位价值

Value of color Doppler imaging in the diagnosis and location of lower extremity perforating venous insufficiency

目的探讨超声在下肢穿静脉功能不全中的诊断与定位价值。方法分析123例(155条)下肢浅静脉曲张患者术前穿静脉超声检查与定位的临床资料,并与手术结果比较。结果155条下肢,CDFI共检出病理性穿静脉193条,其中穿静脉扩张15条,穿静脉功能不全170条,穿静脉血栓8条。手术共结扎穿静脉201条,超声诊断与定位符合率96%。声像图示穿静脉扩张呈管状无回声,垂直或斜行穿越深筋膜和肌层,连接于深、浅静脉间,CDFI示扩张穿静脉内显示由浅入深的蓝色血流信号,或同时出现加压释放实验反向血流持续时间>0.5s,并发血栓时无血流信号。结论超声是准确诊断和定位穿静脉功能不全的重要和首选方法。

Objective To explore the value of color Doppler image in the dagnosis and location of lower extremity perforating venous insufficiency. Methods The clinical ultrasound features of 123 cases （ 155 limbs） with lower extremity varicose superficial veins were retrospectively analyzed and compared with the results of operation. All the cases had a common examination before operation. Results In 123 cases （155 limbs）, 193 abnormal perforating veins were found by CDFI, including 15 venous dilatation, 170 valves insufficiency and 8 thrombosis. Two hundred and one perforating veins were ligated in the operation, the accordance rate of CDFI in diagnosis and location was 96 %. The dilated veins showed anechoic ductus vertically or obliquely through deep fascia and muscularis in sonograms, they were between deep and superficial veins and connected them. CDFI displayed blue blood flow signals from superfical to deep veins, or red regurgitated signals from deep to superficial veins in press- release test. No blood flow signal was observed when there was thrombosis. Conclusion CDFI is important as the first choice in correct diagnosis and location of perforating vein valve insufficiency.