下肢深静脉联合腹部大血管彩超诊断深静脉血栓的价值

Diagnostic Value of Ultrasonography with Deep Veins of Lower Limb and Abdominal Veins for Deep Vein Thrombosis

目的探讨下肢深静脉联合腹部大血管的彩色超声诊断深静脉血栓(DVT)及其病因的临床价值.方法对85例有症状的下肢DVT患者行下肢深静脉的彩超检查,其中68例血栓累及股静脉的患者同时逆行扫查髂静脉及下腔静脉.结果 85例下肢DVT患者急性期51例,亚急性期和慢性期34例,管腔内实性回声、探头加压管腔不被压瘪或消失,CDFI示血流充盈缺损或消失,PW未引出血流频谱或频谱波形不正常是DVT的特征性表现.腹部大血管扫查发现髂静脉和/或下腔静脉内的血栓、瘤栓形成、左侧髂静脉受压综合征、髂静脉炎性粘连等是导致下肢DVT的病因.结论彩色超声对下肢DVT的诊断明确,联合髂静脉、下腔静脉及周围组织的扫查可提高DVT病因的检出率,对制定临床治疗方案有指导意义.

Objective To discuss the clinical value of ultrasonography with deep veins of the lower limbs and abdominal veins for deep vein thrombosis（DVT）.Methods Eighty-five patients with symptomatic DVT were examined deep veins of the lower limbs by color Doppler flowing image（CDFI）.Among them,68 patients involved in thrombosis located in femoral veins were retrograded scanning of the iliac veins and inferior vena cava（IVC）.Results Among 85 cases of DVT in the lower limbs,there were 51 cases in acute stage,34 cases in sub-acute and chronic stages.The ultrasonic features of DVT in the lower limbs were solid echo in the vascular lumen,loss of compressibility of the vein,absence of color Doppler flowing signals or pulse waveform or abnormal spectrum.The causes of DVT in the lower limbs by abdominal veins scanning were thrombosis or malignant embolus located in iliac veins and/or IVC,left iliac vein compression syndrome and inflammatory adhesion of iliac veins.Conclusions Color Doppler ultrasonic diagnosis of DVT in the lower limbs is explicit.Detecting deep vein of the lower limbs combined with iliac veins,IVC and their surrounding tissues can help to explore the causes of DVT and guide clinical treatment.