【作者】 严继萍；

【导师】 雷成功；

【作者基本信息】 山西医科大学 ， 医学影像， 2004， 硕士

【摘要】 [目的] 研究彩色多普勒超声在诊断下肢深静脉有无返流及和评判返流程度中的应用价值。主要探讨返流距离是否可以作为评判下肢深静脉返流程度的指标。 [方法] 应用彩色多普勒超声对 45 例（46 条下肢）经 X 线逆行造影诊断的不同程度的原发性下肢深静脉功能不全的患者和同期无年龄差异的自愿者 20 例（40 条下肢）进行彩色多普勒超声检查，对两组的超声检查结果进行对比分析。本研究重点是对患病组的 X 线逆行造影结果和超声测量的参数进行等级相关性分析。X 线逆行造影结果根据 Kinster 的标准将下肢深静脉功能不全分为四级。彩色多普勒超声检查采用统一的仪器和扫查方法，股浅静脉内返流信号的引出采用统一的乏氏法。将患病组以 X 线逆行造影检查结果为标准，研究平卧位下彩色多普勒检测的股浅静脉内径，乏氏试验时股浅静脉内血流返流时间、返流的距离与 X 逆行造影线检查的返流程度的相关性。 [结果] 超声测量的股浅静脉内返流时间阈值为0.5s为诊断有无下肢静脉功能不全比较合适，与多数研究结果相一致。高分辨率超声可清晰显示静脉壁和瓣膜的解剖结构，为临床提供可靠的静脉及瓣膜的形态学信息，两组均有较高的显示率（对照组为 75%，患病组为 76%）。超声测得股浅静脉内径与 X 线检查的深静脉返流程度相关有高度统计学意义（r=0.771）超声测得股浅静脉返流时间与 X 线检查得深静脉返流程度相关性无统计学意义（r=0.247），但返流的距离和 X 线检查的返流程度相关性有统计学意义（r=0.910）。 [结论] 彩色多普勒为诊断和鉴别诊断原发性下肢静脉功能不全提供可靠的影像学依据。股浅静脉内血流返流的距离是评判静脉返流程度的有用的指标。 超声检测的无创、实时动态、可重复性等优点使超声在判断下肢深静脉返流及返流的程度中发挥重要的作用。更多还原

【Abstract】 [Objective] To study the value of color Doppler ultrasonography indiagnosing the deep venous insufficiency and assessing the severity of deepvenous insufficiency of the lower extremities. And mainly to evaluate thatwhether or not the reflux distance in superficial femoral veins in can be used asa parameter in evaluating the degree of deep venous insufficiency. [Methods] 45 patients (46 lower extremities) in patient group confirmedas venous insufficiency by descending phlebography and 20 volunteers (40lower extremities) in control group were assessed by color Dopplerultrasonography . The results of 45 patients were compared with that of 20volunteers. According to Kinster, the descending phlebography classified theseverity of venous insufficiency in four degrees. All patients and volunteersabove were examined in supine position. Valsalva method was employed inevoking reflux in superficial femoral veins. And the diameters of superficialfemoral vein， the duration of reflux time and the distance of reflux measuredby color Doppler ultrasonography in 45 patients were compared with thedegrees showed in descending phlebography. [Results] It was reasonable that reflux time threshold value of venousreflux in superficial femoral veins was defined as reverse flow for greater than0.5 second by color Doppler ultrasonography. The structure of vein and firstvalve of superficial femoral vein were showed in high-resolutionultrasonography clearly. The diameters of superficial femoral vein measured bycolor Doppler ultrasonography were correlated with the severity of venousreflux showed in phlebography(r=0.771). And the distance of reflux wascorrelated with the severity of venous reflux showed in phlebography(r=0.910).but not the reflux time(r=0.247).[Conclusion] Color Doppler ultrasonography can provide reliable imaging for III<WP=6>doctors in diagnosing and distinguishing deep venous insufficiency. The refluxdistance in superficial femoral vein is useful parameter in assessing the degreeof venous insufficiency. Ultrasonography with its characteristics of non-damage,real-time imaging and reproducibility will play an important role in diagnosingand assessing the severity of deep venous insufficiency.更多还原