血管增强技术联合全景超声成像在下肢急性深静脉血栓介入治疗中的应用

摘要

Objective To investigate the application value of ultrasonic vascular enhancement technology (VET) combined with panoramic ultrasound imaging (PUl) in the interventional treatment of acute deep venous thrombosis (ADVT)of lower limbs. Methods VET and PUl were used to detect 48 veins of lower limbs in 46 patients with ADVT of lower limbs during interventional procedures. The acquired images were compared with those obtained with 2D ultrasound, CDFI and DSA. Then the thrombolytic catheter was moved under dynamic monitoring of VET. Resalts VET could show catheter in the cavity and its top position, boundary contour of undissolved thrombus, small mural thrombus, vascular wall and ambient collateral circulation clearly with less artifacts and interferences. The image quality was better than that of 2D ultrasound and CDFI (P＜0. 05). Compared with DSA, the coincident rate of VET with DSA was 87. 50％ (42/48) for the diameter of the recanalized lumen of femoral vein in the same narrow portion tangent, of 2D ultrasound and CDFI with DSA was 37. 50％ (18/48,x2=25. 60, P＜0. 05). Panoramic images of VET were clear and informative. VET could show the movement of catheter in cavity clearly in dynamic conditions, and under its surveillance, the lateral hole of thrombolytic catheter was put to the vein that contained thrombus accurately. Conclusion VET combined with PUl has great clinical application value in the interventional treatment of ADVT of lower limbs.%目的 探讨超声血管增强技术(VET)联合全景超声成像(PUI)在下肢急性深静脉血栓(ADVT)介入治疗中的应用价值.方法 应用VET及PUI对46例接受下肢ADVT介入治疗患者的48侧下肢血管进行检查,将图像与二维超声及CDFI、DSA进行对比分析,并在VET动态监视下移动溶栓导管.结果 VET图像可清晰显示管腔内导管及其头端位置、未溶血栓边界轮廓、附壁小血栓、血管壁情况及周围侧支循环等,伪像和干扰减少,图像质量评分高于二维超声及CDFI(P<0.05);与DSA比较,VET、二维超声及CDFI股浅静脉再通血管腔同一狭窄段切线位内径测值的符合率分别为87.50%(42/48)、37.50%(18/48,x<'2>=25.60,P<0.05)VET全景图像清晰,内容更丰富;VET动态条件下可较清晰显示腔内导管移动情况,在其监视下可将溶栓导管侧孔段准确置于血栓段血管.结论 VET联合PUI在下肢ADVT介入治疗中具有临床应用价值.