假性血栓性静脉炎的超声诊断价值

Uitrasonographic diagnosis of pseudothrombophlebitis

目的探讨假性血栓性静脉炎的超声诊断价值。方法回顾性分析32例经MRI或穿刺抽液证实的胭窝囊肿合并假性血栓性静脉炎患者的超声特点，并随机抽取64例无症状的胭窝囊肿患者作为对照组，对比分析两组病例声像图表现。结果病例组胭窝囊肿长径及横径均较对照组大[（12．4±4．7）cm×（2．5±0．4）cm对（5．3±2．9）cm×（1．2±0．4）cm，P〈0．001]，且有18例（43．8％）囊肿延伸至小腿；病例组及对照组表现为囊肿透声差或呈囊实性回声者分别为78．1％和9．4％（P=0．000），超声诊断为囊肿并出血或感染；病例组中有6例（18．8％）囊肿远端周围出现不规则无回声区，超声诊断为囊肿破裂，而对照组均无此超声表现（P=0．001）；病例组和对照组均会出现囊内分隔，但差异无统计学意义（P〉0．05）。结论超声对于假性血栓性静脉炎有重要诊断价值，声像图特征包括囊肿较大并延伸至小腿、囊肿透声差或呈囊实性回声、囊肿远端不规则无回声区。

Objective To investigate the ultrasound characteristics of pseudothrombophlebitis. Methods The ultrasound characteristics of thirty-two popliteal cyst cases with pseudothrombophlebitis which were eonfirmed by MRI or puncture were retrospectively analyzed. The former group was matched with a case control group of sixty-four patients with asymptomatic popliteal cysts, the ultrasound images were comparative analysis between the two groups. Results Compared to the control group,both the length and width of the case group were larger [（12.4 ± 4.7）× （2.5 ± 0.4）cm vs （5.3 ± 2.9） × （1.2 ± 0.4）cm, P 〈0. 001],and there were 18（43.8%） cases with the cysts extension into the calf. The case group were more prone to show cyst with poor ultrasound penetration or solid-cystic echo （78.1% vs 9.4%, P = 0. 000） ,which were diagnosed as popliteal cyst with hematoma or infection. Six cases of case group showed irregular anechoic area surrounding the inferior border of the cysts, which were diagnosed as ruptured popliteal cyst,no similar imaging detected in the control group（ P =0. 001 ）. Both the two group showed septation in the cyst,but it did not differ significantly（ P 〉0.05）. Conclusions Ultrasonography is helpful to the diagnosis of pseudothrombophlebitis, the ultrasound characteristics include large cyst extension into the calf,cyst with poor ultrasound penetration or solid-cystic echo and irregular anechoic area surrounding the inferior border of the cysts.