方建强,张彬玉,赵维安,纪亚芸,蒲翠,弥思远.超声及应变式弹性成像预测超声引导下腘静脉置入血管鞘用于治疗下肢深静脉血栓形成成功与否[J].中国介入影像与治疗学,2022,19(6):343-347
超声及应变式弹性成像预测超声引导下腘静脉置入血管鞘用于治疗下肢深静脉血栓形成成功与否
Ultrasound and strain elastography for predicting ultrasound-guided popliteal venous sheath implantation of deep venous thrombosis success or not
投稿时间:2022-01-08  修订日期:2022-01-23
DOI:10.13929/j.issn.1672-8475.2022.06.006
中文关键词:  静脉血栓形成  腘静脉  超声检查  弹性成像技术  导管接触性溶栓
英文关键词:venous thrombosis  popliteal vein  ultrasonography  elasticity imaging techniques  catheter directed thrombolysis
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作者单位E-mail
方建强 咸阳市中心医院超声介入科, 陕西 咸阳 712000  
张彬玉 咸阳市中心医院超声介入科, 陕西 咸阳 712000 laicchang@163.com 
赵维安 咸阳市中心医院超声介入科, 陕西 咸阳 712000  
纪亚芸 咸阳市中心医院超声介入科, 陕西 咸阳 712000  
蒲翠 咸阳市中心医院超声介入科, 陕西 咸阳 712000  
弥思远 咸阳市中心医院超声介入科, 陕西 咸阳 712000  
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中文摘要:
      目的 分析超声及应变式弹性成像预测超声引导下置入腘静脉血管鞘治疗下肢深静脉血栓形成(DVT)成功与否的价值。方法 回顾性分析103例接受超声引导下置入患侧腘静脉血管鞘的DVT患者的术前超声资料,比较置入血管鞘失败与成功病例腘静脉超声及应变式弹性成像表现差异;绘制差异有统计学意义超声参数的受试者工作特征曲线,获得其预测血管鞘置入失败的阈值,对每个参数阈值赋值1分,得到联合超声评分,以实际置入结果为标准,评价超声单一参数及联合评分的预测效能。结果 103例中,对100例行单侧、3例行双侧腘静脉置入血管鞘,包括左侧腘静脉71支、右侧35支,共106支腘静脉;对其中95支腘静脉置入血管鞘成功(成功组),11支失败(失败组)。相比成功组,失败组腘静脉内径及腘静脉与腘动脉内径比值均较小,血栓为等或高回声,与血管壁边界模糊,腘静脉应变式弹性评分为硬。以超声单一参数及联合评分预测置入血管鞘成功与否的曲线下面积分别为0.909、0.926、0.865、0.899、0.958及0.940(P均<0.001)。结论 患侧腘静脉超声及应变式弹性成像能有效预测对下肢DVT患者行超声引导下置入腘静脉血管鞘成功与否。
英文摘要:
      Objective To observe the predictive value of ultrasound and strain elastography for predicting ultrasound-guided popliteal venous sheath implantation success or not in patients with lower lib deep venous thrombosis (DVT). Methods Preoperative ultrasound data of 103 lower lib DVT patients who underwent ultrasound-guided popliteal venous sheath implantation were retrospectively analyzed. Ultrasound scanning and strain elastography manifestations of the involved popliteal veins were compared between libs undergoing successful (success group) and failed (failure group)popliteal venous sheath implantation. The receiver operating characteristic (ROC) curves of ultrasound parameters being statistically different between groups were drawn, and the threshold of the above parameters for predicting ultrasound-guided popliteal venous sheath implantation success or not were obtained. Then the threshold of each parameter was given assignment 1 score to constitute a joint score, and the predictive efficiency of single ultrasonic parameter and joint score were evaluated based on the results of popliteal venous sheath implantation. Results Among 103 cases, ultrasound-guided unilateral popliteal venous sheath implantation was performed in 100 cases, while bilateral implantations were performed in 3 cases, totally in 106 branches of popliteal venous, including 71 branches on the left and 35 branches on the right. There were 95 branches of popliteal venous in successful group, 11 branches in failure group. Compared with those of successful group, the diameter of popliteal vein and diameter ratio of popliteal vein to popliteal artery were both smaller, and more thrombi were isoechoic or hyperechoic, with vague thrombi-venous wall boundary and hard elastic score. The areas under the curve (AUC) of the above single parameter for predicting sheath implantation success or not in patients with lower lib DVT was 0.909, 0.926, 0.865, 0.899, 0.958 and 0.940, respectively (all P<0.001). Conclusion Ultrasound and strain elastography could be used for predicting ultrasound-guided popliteal venous sheath implantation success or not in patients with lower lib DVT.
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