剪切波弹性成像在下肢深静脉血栓分期中的应用价值

Application value of shear wave elastography in the staging of deep venous thrombosis of lower extremities

目的:探讨剪切波弹性成像技术对下肢深静脉血栓分期的应用价值。方法:选取106例下肢深静脉血栓患者(106条患肢),按照发病时间分为急性期组(发病时间<14 d,n=51),亚急性期组(发病时间15~30 d,n=31),慢性期组(发病时间>30 d,n=24)。运用剪切波弹性成像技术测量血栓的杨氏模量值,对各组的杨氏模量值进行组间统计学分析;运用ROC曲线分析得出不同时期血栓的杨氏模量值的截断点。结果:急性期、亚急性期、慢性期血栓杨氏模量平均值分别为(7.81±3.63)、(15.97±2.56)、(28.01±9.59)kPa,三组之间杨氏模量值平均值比较差异有统计学意义(F=116.48,P<0.01),两两之间比较差异有统计学意义(P<0.01)。以杨氏模量值=12.53 kPa为急性期和亚急性期的截断点,曲线下面积为0.96,敏感性为93.5%,特异性为92.2%;以杨氏模量值=19.02 kPa为亚急性期和慢性期的截断点时,曲线下面积为0.918,敏感性为83.3%,特异性为93.5%。结论:剪切波弹性成像技术可以定量测量血栓的杨氏模量值,对判断下肢深静脉血栓的分期有较高的应用价值。

Objective:To investigate the value of shear wave elastography in the staging of deep venous thrombosis of lower extremities.Methods:106 patients with lower extremity deep vein thrombosis(a total of 106 limb)were selected and divided into acute group,subacute stage group and chronic groups according to the onset time.Shear wave elastography technology was adopted to measure Yang's modulus value of blood clots,which was statistically analysed btween each group.Cut-off points of Yang's modulus of thrombus at different stages were obtained by ROC curve analysis.Results:The mean Yang's modulus values of thrombus at acute,subacute and chronic stage were(7.81±3.63)kPa,(15.97±2.56)kPa and(28.01±9.59)kPa respectively.The difference in the mean Yang's modulus values between the three groups was statistically significant(F=116.48,P<0.01).The difference between each two groups was statistically significant(P<0.01).When Yang's modulus value=12.53kpa was taken as the cut-off point of acute and subacute phases,the area under the curve was 0.96,the sensitivity was 93.5%,and the specificity was 92.2%.When Yang's modulus=19.02kpa was taken as the cut-off point of subacute and chronic phases,the area under the curve was 0.918,the sensitivity was 83.3%,and the specificity was 93.5%.Conclusion:Shear wave elastography can quantitatively measure the Yang's modulus value of thrombus,and it is of great value in determining the stage of lower limb deep venous thrombosis.