摘要
目的 研究CT静脉造影(CTV)与彩色多普勒超声(CDS)检查在左髂静脉压迫综合征(IVCS)诊断中的临床价值。方法 选取2022年1月至2023年6月入大庆龙南医院的81例左侧静脉曲张患者作为观察对象,所有患者均接受数字减影血管造影(DSA)检查,参考下肢静脉检查结果有无左IVCS分别作为观察组(n=27)与对照组(n=54)。两组患者均接受CTV或者CDS检查,比较两组患者的CTV左髂静脉前后径、CDS参数(压力梯度、血流速度、前后径),同时比较单一CTV、CDS与CTV联合CDS诊断左IVCS准确性,并采用受试者操作特征(ROC)曲线评估CTV、CDS单独及联合检测对IVCS的诊断价值。结果 观察组患者CTV及CDS左髂静脉前后径分别为(6.09±1.38)、(3.02±0.47) mm,均明显低于对照组[(7.41±1.72)、(5.11±0.58) mm],压力梯度、血流速度分别为(2.69±0.48) mmHg、(40.47±9.25) cm/s,均明显高于对照组[(0.89±0.32) mmHg、(27.53±6.92) cm/s],差异均有统计学意义(P<0.05)。左IVCS诊断中CTV左髂静脉前后径、CDS左髂静脉前后径及联合检查的准确率依次为87.95%、84.34%、91.57%。ROC曲线显示,以10.00 mm为临界值,左IVCS诊断中CTV的ROC曲线下面积(AUC)为0.905,灵敏性为81.47%,特异性为90.38%;CDS的AUC为0.839,灵敏性为74.09%,特异性为88.46%;CTV联合CDS的AUC为0.935,灵敏性为96.28%,特异性为86.49%。结论 左IVCS诊断中IVCS、CDS均具有良好效果,但两种技术联合诊断的准确性、灵敏性更高,早期阶段可为左IVCS诊断提供参考依据。
Objective To study the clinical value of CT venography(CTV) and color Doppler ultrasonograph(CDS) in the diagnosis of left iliac vein compression syndrome(IVCS).Methods Eighty-one patients with left varicose veins admitted to Daqing Longnan Hospital from January 2022 to June 2023 were observed.All patients underwent digital subtraction angiography(DSA),and were divided into the observation group(n=27) and the control group(n=54) according to the results of lower extremity vein examination whether left IVCS occurred.Both groups were examined by CTV or CDS.The anterior and posterior diameters of CTV left iliac vein and CDS indexes(pressure gradient,blood flow velocity,anterior and posterior diameters) were compared between the two groups.At the same time,the diagnostic accuracy of single CTV,CDS and CTV combined with CDS was compared,and the diagnostic value of CTV and CDS in IVCS was evaluated by receiver's operating characteristics(ROC) curve.Results The CTV and CDS anterior and posterior diameters of the left iliac vein in the observation group were(6.09±1.38) and(3.02±0.47) mm,respectively,which were significantly lower than those in the control group [(7.41±1.72) and(5.11±0.58) mm],the pressure gradient and blood flow velocity were(2.69±0.48) mmHg and(40.47±9.25) cm/s,respectively,which were significantly higher than those in the control group [(0.89±0.32) mmHg and(27.53±6.92) cm/s],and the differences were statistically significant(P<0.05).In the diagnosis of left IVCS,the accuracy of CTV left iliac vein anteroposterior diameter,CDS left iliac vein anteroposterior diameter and combined examination were 87.95%,84.34% and 91.57%,respectively.The ROC curve showed that the area under the ROC area under curve(AUC) of CTV in the diagnosis of left IVCS was 0.905,the sensitivity was 81.47%,and the specificity was 90.38%.The AUC of CDS was 0.839,the sensitivity was 74.09%,and the specificity was 88.46%.The AUC of CTV combined with CDS was 0.935,the sensitivity was 96.28%,and the specificity was 86.49%.Conclusion Both IVCS and CDS have good results in the diagnosis of left IVCS,but the combined diagnosis of the two techniques is more accurate and sensitive,and can provide reference for the diagnosis of left IVCS in the early stage.
作者
陈春梅
王琪
石岩峰
CHEN Chun-mei;WANG Qi;SHI Yan-feng(Department of CT Magnetic Resonance Diagnosis,Daqing Longnan Hospital,Daqing Heilongjiang 163458,China)
出处
《临床和实验医学杂志》
2024年第8期875-879,共5页
Journal of Clinical and Experimental Medicine
基金
黑龙江省卫生健康委员会科研课题(编号:2019-378)。
