彩色多普勒超声检查联合超声弹性成像对初次全髋关节置换术后下肢深静脉血栓形成的分期诊断价值

Color Doppler ultrasound combined with ultrasound elasticity imaging for staging diagnosis of deep vein thrombosis after primary total hip replacement

目的探讨彩色多普勒超声联合超声弹性成像对初次全髋关节置换术后下肢深静脉血栓形成的分期诊断价值。方法筛选32例初次全髋关节置换术后下肢深静脉血栓患者并根据患者症状开始时间将其分为急性期、亚急性期和慢性期血栓组。观察各组血栓的彩色多普勒超声和超声弹性图像特点,通过血栓超声弹性图像评分及血栓应变比值半定量评估不同分期血栓的弹性特征。结果急性期血栓彩色多普勒超声表现为低回声或等回声声影,超声弹性成像以红色为主;亚急性期血栓彩色多普勒超声表现为等回声或稍增强回声声影,超声弹性成像以绿色为主;慢性期血栓彩色多普勒超声表现为强回声声影,超声弹性成像以蓝色为主。慢性血栓组及亚急性血栓组超声弹性图像评分及血栓应变比值高于急性血栓组(P<0.05),慢性血栓组超声弹性图像评分及血栓应变比值高于亚急性血栓组(P<0.05)。结论彩色多普勒超声联合超声弹性成像对初次全髋关节置换术后下肢深静脉血栓形成的分期诊断具有一定的临床意义。

Objective To investigate the diagnostic value of color Doppler uhrasound combined with ultrasound elasticity imaging for deep vein thrombosis in different stages after primary total hip replacement. Methods 32 patients of deep vein thrombosis after primary total hip replacement were divided into acute thrombosis group, sub-acute thrombosis group and chronic thrombosis group. Each thrombus was detected by color Doppler ultrasound and ultrasound elasticity imaging. The characteristics of thrombosis were evaluated by establishing five scores rating and the strain ratio. Results In color Doppler ultrasound, the acute thrombosis was low or equal level echo, the sub-acute thrombosis was equal or hypo- enhancement level echo, and the chronic thrombosis was high level echo. In ultrasound elasticity image, the acute thrombosis was mainly red, the sub-acute thrombosis was mainly green, and the chronic thrombosis was mainly blue. The five scores rating and the strain ratio of sub-acute thrombosis group and chronic thrombosis group were higher than those of acute thrombosis group. The five scores rating and the strain ratio of chronic thrombosis group were higher than those of sub-acute thrombosis group. Conclusions Color Doppler ultrasound combined with ultrasound elasticity imaging can be used to diagnose the deep vein thrombosis in different stages after primary total hip replacement.