超声造影对小腿肌间静脉血栓的诊断价值

Value of contrast enhanced ultrasound in the diagnosis of calf muscular venous thrombosis

目的探讨超声造影对小腿肌间静脉血栓的诊断价值。方法选取2013年7月至2014年6月在东莞市中医院骨科住院,并诊断为单纯性小腿肌间静脉栓塞的患者25例作为研究对象(1支或以上血栓形成)。选取未患有小腿肌间静脉血栓者15例作为对照组。所有受检者行双侧腘静脉超声造影检查,分析双侧腘静脉造影剂灌注特征;并行时间-强度曲线定量分析,获得定量参数造影剂到达时间(AT)、达峰时间(TTP)以及峰值强度(PI)。结果所有腘静脉均表现为均匀、完全充填,未见明显充盈缺损。研究组患侧造影剂AT、TTP分别为(53.6±10.3)s、(58.4±7.2)s,较健侧[(40.2±7.2)s、(48.8±5.8)s]明显延长,差异具有统计学意义(t=7.556、7.475,P值均<0.01);患侧与健侧PI间差异无统计学意义(P>0.05)。对照组双侧造影参数间无显著差异(P>0.05)。进一步将对照组双侧与研究组健侧造影参数进行组间比较,差异无统计学意义(P>0.05)。结论超声造影能够反映小腿肌间静脉血栓形成时腘静脉的血流动力学变化,可提高对血栓形成可疑病例的诊断。

Objective To evaluate the value of contrast enhanced ultrasound in the diagnosis of calf muscular venous thrombosis. Methods Twenty-five cases of unilateral isolated calf muscular venous thrombosis and 15 cases with no calf muscular venous thrombosis were included in this study. They were all in-patients in Dongguan Hospital of Traditional Chinese Medicine from July 2013 to June 2014. All patients were examined using contrast enhanced ultrasound to analyze the hymodynamic characterics of bilateral femoral vein. The quantitative parameters of contrast enhanced ultrasound including arrival time（AT）, time to peak（TTP） and peal intensity（PI） were acquired and analyzed. Results All femoral veins were filled with contrast agents homogeneously and completely with no filling defect. AT and TTP of the femoral veins in the same lateral with calf muscular venous thrombosis were significantly longer than those of the contralateral femoral veins [（53.6±10.3） s vs（40.2±7.2） s,（58.4±7.2） s vs（48.8±5.8） s, both P〈0.01]. PI of the bilateral femoral veins had no significant difference [（-51.5±8.1） d B vs（-53.3±8.7） d B, P〉0.05]. All the quantitative parameters had no significant differences between the bilateral femoral veins in the persons with no calf muscular venous thrombosis（P〉0.05）. And all the quantitative parameters had no significant differences among the unaffected-lateral femoral veins in the patients with calf muscular venous thrombosis and the bilateral femoral veins in the patients with no calf muscular venous thrombosis（P〉0.05）. Conclusion Contrast enhanced ultrasound can reflect the hemodynamic change of femoral veins caused by calf muscular venous thrombosis and enhanced the diagnostic confidence to calf muscular venous thrombosis.