高频超声诊断孤立性小腿肌间静脉血栓的价值

摘要

目的：探讨高频超声对孤立性小腿肌间静脉血栓的诊断价值。方法回顾性分析临床确诊的175例（190条）孤立性小腿肌间静脉血栓的声像图特征并与临床随访结果进行对比分析。结果175例（190条）孤立性小腿肌间静脉血栓，高频超声正确诊断158例（173条），误诊7例（7条），漏诊10例(10条），诊断准确率91.1%（173/190）。误诊7例分别为神经纤维瘤1例，混合型血管瘤1例，腓肠肌血肿5例。所有患者发现后均进行溶栓及抗凝治疗，治疗后1、3、6个月复查彩色多普勒超声，血流部分再通或完全再通，均无小腿深静脉主干蔓延。小腿肌间静脉血栓声像图特征：静脉管腔明显增宽，管腔内低回声充填，长轴呈管状或树枝状，短轴为圆形或椭圆形，适度加压管腔不能被压瘪，管腔内大多无血流信号显示。结论高频彩色多普勒超声可以显示血栓的位置、形态、类型、管腔阻塞情况及血流状态，有助于明确诊断孤立性小腿肌间静脉血栓，同时对治疗效果可以进行动态评估。%Objective To explore the clinical value of high-frequency color Doppler ultrasound in the diagnosis of isolated calf muscle vein thrombosis (ICMVT). Methods Sonographic features of 175 patients with isolated calf muscular venous thrombosis were analyzed retrospectively and outcome of anticoagulant therapy in 1, 3, and 6 months was followed up. Diagnosis was established with high-frequency color Doppler ultrasound examination. Results One hundred and seventy-ifve patients presenting with 190 calf muscle vein thrombosis were included. One hundred and iffty-eight cases with 173 calf muscle vein thrombosis were diagnosed by high-frequency color Doppler ultrasound, 7 cases of misdiagnosis, missed diagnosis in 10 cases. The accuracy rate was 91.1%(173/190). Seven cases were misdiagnosed with 1 euroifbromatosis, 1 mixed hemangioma, 5 gastrocnemius hematoma. After diagnosis of ICMVT, all patients prescribed thrombolysis and anticoagulation therapy. High-frequency color Doppler ultrasound for 1, 3, 6 months after treatments revealed partial or complete recanalization without calf deep vein thrombosis. Typical sonographic features included:calf muscle venous lumen dilation, tortuous anechoic lumen or hypoechoic iflling, with tubular or branched shape in the longitudinal view and oval or round shape in the transversal view. Conclusion High-frequency color Doppler ultrasound is an accurate and reliable method in the diagnosis of the isolated calf muscular venous thrombosis.