彩色多普勒超声在静脉畸形骨肥大综合征诊断中的应用

Application of the color Doppler ultrasound in diagnosing Klippel-Trenaunay syndrome

目的探讨彩色多普勒超声对静脉畸形骨肥大综合征(KTS)的诊断价值。方法回顾性分析2014年1月~2017年1月,我科诊治的59例KTS患者彩色多普勒超声检查资料。采用高频探头自双侧股总静脉、股浅静脉、股深静脉、腘静脉、大隐静脉、隐静脉自上而下进行常规静脉筛查,观察双侧大隐静脉及小隐静脉是否曲张,深、浅静脉有无静脉瓣功能不全、静脉管腔内有无血栓以及深静脉有无缺如及变异,同时观察患肢皮下软组织有无增厚、淋巴管有无扩张,有无血管瘤样病变等。然后,沿下肢后外侧从上至下寻找有无增粗的浅静脉,并以患肢皮肤色素改变水平为重点,增大检测范围,观察有无较多的深浅静脉交通支。结果超声检查均发现患侧肢体增粗、增长,同时伴有不同程度的浅静脉曲张,并伴有较多深浅静脉交通支,其中有7例(11.86%)伴有深静脉缺如。结论超声、CT血管造影、核磁血管造影等敏感性及特异性均较高,而随着彩色多普勒超声的高分辨率仪器和高频探头在临床上的广泛应用和经验积累,超声均可检出血管的改变,对KTS的诊断具有重要的临床应用价值。

Objective To discuss the diagnosis value of the color doppler ultrasound in Klippel-Trenaunay syn- drome. Method 59 KTS patients were analyzed. The data of the color Doppler ultrasound diagnoses ranged from January 2014 to January 2017. Femoral vein, superficial femoral vein, deep femoral vein, popliteal vein, great saphenous vein and saphenous vein were detected with high frequency probe. The varicosity of great saphenous vein and saphenous vein, thickening of subcutaneous soft tissue, intraductal thrombosis, absence and variation of deep vein, venous insufficiency and lymphangiectasis were observed. Results All of patients had wide and growth lateral limbs, superficial varicose veins , vena profunda and vena superficialis rami communicans. 29 cases were male in average age 34.5 years. 30 cases were female in average age 26.9 years. Moreover, 7 cases hadn＇t vena profunda. Conclusion It has important clinical application value of the color Doppler ultrasound in KTS diagnoses. It is high sensitive and specific of ultrasound, CT angiography, NMR angiography and so on. Along with widely applying high-resolution instrument and high-frequency probe of ultrasound medicine in clinic, the sensitive rate and detection rate of ultrasound vascellum detection is approved.