彩色多普勒血流显像诊断原发性下肢深静脉瓣功能不全的价值

The Value of Color Doppler Flow Imaging in the Diagnosis of the Primary Deep Venous Incompetence

目的 探讨彩色多普勒血流显像 (CDFI)判断原发性下肢深静脉瓣膜功能不全 (PDVI)及其程度的应用价值。方法 应用CDFI检查了 3 7例PDVI患者 (5 7条腿 )和 3 0例对照组 (60条腿 )的下肢股静脉和月国静脉最大返流时间(RT) ,以逆行深静脉造影的四级分类法将PDVI分为 1、2、3、4共四级。结果 ①正常对照组静脉瓣返流时间RT =0 .2 1± 0 .14s ;②病变组各级静脉瓣返流时间分别为 :1级 (3 0条腿 )RT =1.42± 0 .2 4s ;2级 (15条腿 )RT =2 .49± 0 .3 4s ;3级(10条腿 )RT =3 .75± 0 .5 2s ;4级 (2条腿 )RT =6.2 8± 0 .18s ;病变组与正常对照组及病变组各级之间RT比较 ,均有显著性差异 (P <0 .0 5 )。③RT (95 % )正常参考上限值为 0 .48s ,以RT 0 .5s作为判断生理性与病理性深静脉瓣膜返流的界限值 ,则其灵敏度为 93 % ,特异度为 77% ,阳性预期值为 88% ,阴性预期值为 85 %。结论 CDFI可判断下肢深静脉瓣膜返流及其程度 。

Objective To evaluate the value of color Doppler flow imaging (CDFI) in diagnosing the primary deep venous incompetence (PDVI) and the degree of blood reflux.Methods The maximal blood reflux time (RT) of 37 cases(57 limbs) with PDVI and 30 cases (60 limbs) of normal subjects were studied by CDFI. According to the results of phlebography, the degree of blood reflux were graded respectively on a scale of 1～4. Results ① The blood reflux time of normal subjects were 0.21±0.14 s; ②the blood reflux time of PDVI were respectively : 1 grade RT=1.42±0.24 s ,2 grade RT= 2.49±0.34s,3 grade RT= 3.75±0.52s,4 grade RT=6.28±0.18 s;There were significant difference between the patients with PDVI and the normal group (P < 0.05).③ The RT 95% upper limit value was 0.48 s,RT>0.5s was considered to be criteria to diagnose physiological and pathological valvular reflux .The sensitivity of this criteria was 93%,the specificity was 77%,the positive predictive value was 88%,the negative predictive value was 85%.Conclusions CDFI characterized the severe degree of lower extremities deep venous reflux and has great practical value for clinical diagnosis and operation.