彩色多普勒超声诊断下肢静脉血栓临床价值

Clinical value of color doppler ultrasound in the diagnosis of thrombus of lower extremity veins

目的探讨彩色多普勒超声对下肢静脉血栓(DVT)的诊断价值。方法对84例疑诊为下肢DVT的患者分别采用彩色多普勒超声和数字减影血管造影(DSA)检查,对检查结果进行对比分析。结果所有84例患者中,彩超诊断下肢DVT68例,左下肢49例(72.1%),右下肢19例(27.9%),左侧明显多于右侧;所有68例患者中,急性期39例,亚急性期20例,慢性期9例。DSA检查诊断下肢DVT66例。彩超诊断68例中,64例DSA检查诊断为下肢DVT,4例DSA检查阴性。彩超检查正常18例中,2例经DSA检查诊断为下肢DVT。与DSA检查结果比较,彩超诊断DVT敏感性为96.97%,特异性为88.9%,两种检查方法一致性好(Kappa值为0.78)。结论彩色多普勒超声检查简便、快捷、具有可重复性,与DSA检查一致性好,在下肢DVT的诊断中具有重要价值。

Objective To investigate the clinical value of color doppler ultrasound in the diagnosis of thrombus of lower extremity veins. Methods A total of 84 patients with thrombus of lower extremity veins（DVT） underwent color Doppler ultrasound and digital subtraction angiography（DSA）, and analyzed the test results comparatively. Results Color doppler ultrasound diagnosed deep vein thrombosis（DVT） in 68 cases of all 84 patients, 49 cases were in the left lower extremity（72.1%）, 19 cases were in the right lower extremity（27.9%）,patients were in the left more than in the right; In all 68 patients,39 cases were in acute stage,20 cases were in sub acute stage, 9 cases were in chronic period.DSA diagnosed lower extremity DVT in 66 cases in 68 cases diagnosed by color doppler ultrasound,DSA diagnosed lower extremity DVT in 64 cases, 4 cases that examined by DSA were negative. Color doppler ultrasound diagnosed normal in 18 cases, DSA found lower extremity DVT in 2 cases. Compared with the results of DSA examination, the sensitivity and the specificity of color doppler ultrasound for diagnosing DVT were 96.97% and 88.9%, the diagnostic consistency of both methods was high（Kappa=0.78）. Conclusion Color doppler ultrasound is simple, fast and reproducible, it is high in consistency with DSA and has important value in the diagnosis of lower extremity DVT.