磁共振血管成像诊断髂静脉压迫综合征临床价值研究

Clinical value of MRV in diagnosis of iliac vein compression syndrome

目的通过经股静脉插管造影验证磁共振血管成像(MRV)诊断髂静脉压迫综合征的临床应用价值。方法选取浙江中医药大学附属温岭中医院2017年10月至2020年9月收治按国际静脉联盟临床分级(CEAP分级)C3及以上的静脉曲张病人309例,其中C3病人69例、C4病人94例、C5病人57例、C6病人89例。采用磁共振检查下腔静脉和髂静脉,根据MRV检查结果髂静脉狭窄>50%的病人行股静脉造影,对其结果进行综合分析。结果309例CEAP C3~C6病人通过MRV检查发现髂静脉中度以上狭窄192例,阳性率为59.33%(192/309),其中160例行经股静脉造影检查,证实髂静脉中度以上狭窄120例;MRV与造影检查证实,静脉曲张病人中髂静脉中度以上狭窄符合率为75%(120/160)。结论MRV可作为临床诊断髂静脉压迫综合征的一种重要无创检查方法,为进一步治疗提供可靠的诊断依据。

Objective To investigate the clinical value of magnetic resonance venography(MRV)in the diagnosis of iliac vein compression syndrome by combining with femoral venous intubation.Methods A total of 309 cases of varicose veins in Wenling Traditional Chinese Medical Hospital Affiliated to ZheJiang Chinese Medical University from October 2017 to December 2020,according to the International Union of Phlebology(CEAP classification)above C3,including 69 patients with C3,94 with C4,57 with C5 and 89 with C6,were selected.MRV was used to examine the inferior vena cava and iliac vein.According to the results of MRV,femoral venography was performed in more than 50%of patients with iliac vein stenosis.Results In 309 patients with CEAP C3~C6,192 patients with moderate or above stenosis of iliac vein were found by MRV.The positive rate was 59.33%(192/309).Among them,160 cases underwent femoral venography,which confirmed 120 cases of iliac vein stenosis.MRV and contrast examination confirmed that the coincidence rate of ilium vein stenosis was 75%(120/160).Conclusion MRV can be used as an important noninvasive examination method for clinical diagnosis of iliac vein compression syndrome,and provide reliable diagnostic basis for further treatment.