超声造影在骨伤患者小腿深静脉血栓诊断中的应用价值
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1.内蒙古医科大学第二附属医院;2.内蒙古自治区妇幼保健院

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2022年度自治区高等学校青年科技人才发展计划,内蒙古医科大学青年创新基金项目,内蒙古医科大学2021年度高等教育教学改革研究项目.


The diagnosis value of CEUS in Suspected Deep Vein Thrombosis after lower leg fracture
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The Second Affiliated Hospital of Inner Mongolia Medical University

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2022 Development Plan for Young Scientific and technological Talents in Colleges and universities of Autonomous Region ,Inner Mongolia Medical University Youth Innovation Fund.Inner Mongolia Medical University 2021 higher education teaching reform research project

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    摘要:

    目的 观察骨伤后可疑小腿深静脉血栓患者超声造影表现,分析TIC (Time–Intensity Curves)曲线与血浆D -二聚体(D-dimmer)升高程度的相关性,探讨超声造影在诊断骨伤患者下肢可疑深静脉血栓的应用价值。

    Abstract:

    Objective To observe the performance of CEUS in patients with suspected deep vein thrombosis (DVT) after bone injury, analyze the correlation between the TIC (time-intensity Curves) and the increased degree of plasma D-dimmer, Then discuss the value of CEUS in diagnosis of DVT in patients with bone injury. Methods A total of 57 suspected Deep venous DVT patients who were unable to be diagnosed by conventional ultrasound after lower limb fractures from May 2019 to May 2021 were collected, all of which has only one lower limb fractures, which could not be scanned under pressure due to fracture displacement and lower limb soft tissue swelling.The ipsilateral deep vein without thrombosis was used as the control vessel. Angiography was performed on 57 lower limbs to observe the contrast agent perfusion. TIC curve analysis and comparison were started after the angiography:Area under the curve, contrast agent arrival ATm (Start frame time of CINE), time to peak intensity from the first frame of CINE (TtoPK), the time of pesk intensity is calculated by C/K, and mean-square differential MSE: Mean Square Error between actual data and fitting curve, curve Gradient between Start frame to Peak frame, and dValue (The amount of intravascular abstract contrast agent increased) were compared and measured.The correlation between TIC curve and D-dimer concentration was analyzed.Results ①. Of the 57 patients, 34 patients showed "truncation sign" the contrast agent filling defect of the thrombus.The incidence of PEV was higher than PTV, and the difference was statistically significant (χ2=13.342a, P<0.01).In 23 patients, the contrast agent arrived at the suspected thrombus slowly and showed slow flow. ②. TIC curve analysis was performed on 34 patients diagnosed with DVT: compared with control vessels, there were statistically significant differences in Area under the curve (T=6.265 P=0.018) and dValue (T=5.547 P<0.01). ③.Multivariate logistic regression showed that the more greater difference in dValue compared with the control vessels, the more possibility of thrombosis. P=0.041, 95.0% C.I(1.012-1.730).

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窦蕊,冯荣光,邓琦,赵平,刘慧,栗平.超声造影在骨伤患者小腿深静脉血栓诊断中的应用价值[J].临床超声医学杂志,2022,24(7):512-516

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  • 收稿日期:2021-11-01
  • 最后修改日期:2022-06-05
  • 录用日期:2021-12-02
  • 在线发布日期: 2022-08-01
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