彩色多普勒超声在肠系膜上静脉血栓诊断中的应用价值

摘要

Objective To study the clinical value of color Doppler ultrasonography in the diagnosis of superior mesenteric vein thrombosis.Methods A total of 96 patients with superior mesenteric vein thrombosis,who admitted to Chinese PLA General Hospital from January 2015 to January 2017,were enrolled in this study.All patients underwent color Doppler ultrasonography, the ultrasonographic features of the patients were analyzed, and computed tomography venography(CTV)examination was performed in one hour.Taking CTV examination as a standard,the overall sensitivi-ty, specificity and misdiagnosis rate of color Doppler ultrasonography were evaluated, and the difference of detection rate of superior mesenteric venous thrombosis by color Doppler ultrasonography in three time periods of 1-3 d,4-7 d and 8-11 d was statistically analyzed. Results The color Doppler ultrasonography results showed filling defect of blood flow signal and even no biood flow signal in the initial segment of portal vein and part of the main trunk in 62 cas-es,which can be diagnosed as the formation of superior mesenteric vein thrombosis;Other 34 cases were diagnosed as non-superior mesenteric vein thrombosis,including 7 cases of venous hypoechoic group and 27 cases of blood flow sig-nal filling without obvious loss.The overall sensitivity and specificity of color Doppler ultrasound examination for superi-or mesenteric venous thrombosis were 89.39%,90.00%,respectively,with the results of CTV examination as the standard. The detection rates of superior mesenteric vein thrombosis in the three time periods of 1-3 d, 4-7 d and 8-11 d were 86.84%,93.33%,91.70%,respectively(P>0.05).Conclusion Color Doppler ultrasonography can be used for early di-agnosis of patients with superior mesenteric vein thrombosis,which has high clinical value.%目的 研究彩色多普勒超声对肠系膜上静脉血栓诊断的临床价值.方法 选取2015年1月至2017年1月中国人民解放军总医院收治且疑诊为肠系膜上静脉血栓96例患者为观察对象,所有患者先行彩色多普勒超声检查,分析其超声声像图特点,而后于1 h内再次行CT静脉成像(CTV)检查,以CTV检查为标准,评价彩色多普勒超声检查整体灵感度、特异度及误诊率,并统计分析发病3d内、4~7d及8~11d三个时间段患者彩色多普勒超声检查肠系膜上静脉血栓的检出率的差异性.结果96例患者经彩色多普勒超声检查结果显示,其中62例患者门静脉起始段及部分主干内可见血流信号充盈缺损甚至无彩色血流信号,可诊断为肠系膜上静脉血栓已形成;34例诊断为非肠系膜上静脉血栓,其中7例静脉内低回声团,27例血流信号充盈无明显损缺;以CTV检查结果为标准判定彩色多普勒超声检查肠系膜上静脉血栓整体灵敏度、特异度分别为89.39%、90.00%;且发病3 d内、4~7 d及8~11 d三个时间段患者彩色多普勒超声检查肠系膜上静脉血栓的检出率分别为86.84%、93.33%、91.70%,三个时间段检出率比较差异无统计学意义(P>0.05).结论 彩色多普勒超声对肠系膜上静脉血栓患者可实现早期诊断,具有较高的临床价值.