下肢慢性静脉功能不全影像学诊断及评价

Imaging diagnosis and evaluation for chronic venous insufficiency of the lower limbs

下肢慢性静脉功能不全(CVI)是一种常见临床疾病,主要是因为原发或者继发深静脉瓣膜功能不全引起静脉反流导致静脉压升高,继而出现一系列病理生理改变及多样临床症状表现,严重影响病人生活质量,如何明确诊断对于治疗和改善病人预后有着重要意义。CVI病人的症状和体征对其静脉功能评估的特异度通常较低;单纯病史和体格检查不能完全明确静脉解剖和功能异常及程度,所以准确的检查手段非常重要。目前各种影像学检查手段如彩色多普勒超声(CDU)、CT静脉成像(CTV)、磁共振静脉成像(MRV)、数字减影血管造影(DSA)和血管腔内超声(IVUS)等能对下肢静脉阻塞和反流情况进行很好的评估,从而为临床明确诊断及治疗提供重要依据。

Chronic venous insufficiency(CVI)of the lower limbs is a common clinical disease,mainly caused by primary or secondary deep venous valve insufficiency,which leads to venous reflux and elevated venous pressure,followed by a series of pathological and physiological changes and diverse clinical symptoms,this seriously affecting the quality of life of patients.How to make a clear diagnosis is very important for treatment and improvement of patient prognosis.The specificity of the symptoms and signs of CVI patients to evaluate their venous function is usually low.Simple medical history and physical examination cannot fully clarify the degree and anatomy of venous anatomy and functional abnormalities,so accurate examination methods are very important.At present,various imaging examination methods such as color Doppler ultrasound(CDU),CT venography(CTV),magnetic resonance venography(MRV),digital subtraction angiography(DSA),and intravascular ultrasound(IVUS)can effectively evaluate venous obstruction and reflux of the lower limbs,providing important basis for clinical diagnosis and treatment.