摘要
目的:探讨双源CT直接静脉造影(direct dual-source computed tomography venography,DSCTV)在协助诊断及治疗下肢静脉性溃疡中的价值。方法:收集因下肢静脉性溃疡行DSCTV检查的患者资料,评价重建图像质量、浅静脉曲张部位;分析静脉曲张来源,比较DSCTV与超声多普勒(Duplex ultrasound,DUS)检出功能不全静脉结果;评估下肢溃疡与局部曲张浅静脉关系并与临床评估结果对比。结果:本组47条患肢图像质量总体良好,发现浅静脉曲张共99处;DSCTV检出深静脉血栓(deep vein thrombosis,DVT)5例患肢,余42例患肢均考虑慢性下肢静脉功能不全(chronic venous insufficiency,CVI):与DUS对比检出功能不全深静脉(deep veins,DV)及大隐静脉(great saphenous veins,GSV)无统计学差异(P=0.70、P=0.51),一致性分析Kappa值分别为0.69及0.53;检出不全穿静脉(perforator veins,PV)差别有统计学意义(P<0.005),DSCTV检出率高于DUS;下肢皮肤溃疡与局部浅静脉曲张关系DSCTV判定与临床评估结果对比无统计学差异(P=0.41)。结论:DSCTV可显示曲张静脉分布,提示曲张来源,同时显示参照结构(如骨骼、肌肉及皮肤等),能较好地指导下肢静脉性溃疡患者的临床诊断及治疗。
Objective：To assess the diagnostic value of direct dual-source computed tomography venography（DSCTV）in lower-limb venous ulcers. Methods：Clinical data of patients with suspected lower-limb venous ulcers were collected. With DSCTV,the reconstructed image quality and sites of varicose veins were evaluated;sources of varicose were analyzed,and detection of incompetent veins by DSCTV and duplex ultrasound（DUS）were compared;relations between ulceration and local varicosity were assessed and compared with clinical evaluation. Results：The overall image quality of all 47 affected legs was good. Using DSCTV,99 varicose veins were detected,5 limbs were diagnosed as deep vein thrombosis,and the rest 42 limbs were considered as chronic venous insufficiency,having no difference compared with DUS in detecting incompetent deep veins and great saphenous veins（P values were 0.70 and 0.51;Kappa values were 0.69 and 0.53）. However,the detection rate of incompetent perforator veins was statistically higher in DSCTV than in DUS（P＆lt;0.005）. There was no statistically significant difference between DSCTV and clinical evaluation regarding to relation between ulceration and local varicosity（P=0.41）. Conclusions：DSCTV can provide information about sites and sources of varicose veins,together with referential structures（skin,muscles or bones）,thus could guide diagnosis and treatment in patients with lower-limb venous ulcers.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2014年第5期733-736,共4页
Journal of Chongqing Medical University
基金
国家临床重点专科建设资助项目(编号:国卫办医函[2013]544号)
