彩色血流双功超声对高危患者孤立性小腿静脉血栓形成的检测是一种好的诊断测试吗？

Is color-flow duplex a good diagnostic test for detection of isolated calf vein thrombosis in high-risk patients?

作者信息

Eskandari M K, Sugimoto H, Richardson T, Webster M W, Makaroun M S

机构信息

Division of Vascular Surgery, The University of Pittsburgh Medical Center, Pennsylvania, USA.

出版信息

Angiology. 2000 Sep;51(9):705-10. doi: 10.1177/000331970005100901.

DOI:10.1177/000331970005100901

PMID:10999610

Abstract

Color-flow duplex scanning (CDS) is a good diagnostic test for lower extremity proximal deep vein thrombosis (DVT). This report aims to evaluate the diagnostic accuracy of CDS in detecting isolated calf DVT in two in-hospital populations. A total of 166 patients had routine DVT testing with both CDS and venography: 99 total joint arthroplasty patients and 67 symptomatic in-hospital patients. Isolated calf DVT was noted in 34% of arthroplasty patients and 12% of symptomatic in-hospital patients. Peroneal DVT was most common. The sensitivity, specificity, positive predictive value, and negative predictive value (with 95% confidence interval [CI]) of CDS in detecting isolated calf DVT in the symptomatic in-hospital group was 39% (16%-62%), 98% (94%-99%), 88% (65%-99%), and 81% (71%-91%), respectively. In the arthroplasty patients these values were 13% (3%-23%), 92% (85%-99%), 60% (30%-90%), and 55% (45%-65%), respectively. CDS has a low sensitivity in detecting isolated calf DVT among hospitalized patients and cannot be deemed an effective tool for identifying clots limited to only one or two tibial vessels.

摘要

彩色血流双功扫描（CDS）是诊断下肢近端深静脉血栓形成（DVT）的一种良好检查方法。本报告旨在评估CDS在两个住院人群中检测孤立性小腿DVT的诊断准确性。共有166例患者接受了CDS和静脉造影的常规DVT检查：99例全关节置换患者和67例有症状的住院患者。在34%的关节置换患者和12%的有症状住院患者中发现了孤立性小腿DVT。腓静脉DVT最为常见。在有症状的住院组中，CDS检测孤立性小腿DVT的敏感性、特异性、阳性预测值和阴性预测值（95%置信区间[CI]）分别为39%（16%-62%）、98%（94%-99%）、88%（65%-99%）和81%（71%-91%）。在关节置换患者中，这些值分别为13%（3%-23%）、92%（85%-99%）、60%（30%-90%）和55%（45%-65%）。CDS在检测住院患者孤立性小腿DVT方面敏感性较低，不能被视为识别仅局限于一两条胫静脉血管内血栓的有效工具。