Daher A, Jones V, da Silva A F
Department of Surgery, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD, U.K.
Eur J Vasc Endovasc Surg. 2001 Apr;21(4):350-2. doi: 10.1053/ejvs.2000.1267.
continuous wave Doppler (CWD) has good discriminatory power at the groin in the assessment of saphenous femoral junction (SFJ); however, it is not as accurate as duplex ultrasound scanning (DUS) in the popliteal fossa for assessment of saphenous popliteal junction (SPJ) in patients with primary short saphenous vein incompetence.
the aim of this study was to compare the findings of CWD with those of DUS at the SPJ and assess the role of popliteal vein incompetence in the accuracy of CWD.
prospective study of consecutive patients presenting to a vein clinic requiring a duplex scan of their SPJ. Each patient was examined by one surgeon using CWD and by one radiologist using DUS. Each observer was unaware of the other's findings. Additional information on the competence of the popliteal vein on DUS was also recorded.
some 171 limbs in 128 patients with varicose veins were studied. One hundred and sixteen limbs had reflux at SPJ on CWD whilst 55 did not. Their mean age was 54 (range 18-85). Female to male ratio was 3:1. Spearman's rank correlation between CWD and DUS has 0.49 (p =0.0001). CWD has a sensitivity of 92% and specificity of 53% (PPV=62%, NPV=89%, accuracy=70%). Twenty-nine limbs had an incompetent popliteal vein (IPV). Of those, 12 limbs also had incompetence on CWD and competence on DUS at the SPJ, which represent 28% of the total number of limbs with these findings (n =43).
CWD is sensitive in detecting incompetence at SPJ, though its specificity is low. In this study 17% (n =29) of all patients had incompetence of popliteal vein. Up to 25% ( n =12) of patients with SPJ incompetence on CWD (Doppler +) and competence on DUS (duplex -) had incompetence of the underlying popliteal vein, which may explain the low specificity. The presence of SPJ incompetence on CWD should be confirmed on DUS prior to surgery.
连续波多普勒（CWD）在评估大隐股静脉交界处（SFJ）时，在腹股沟处具有良好的鉴别能力；然而，对于原发性小隐静脉功能不全的患者，在腘窝处评估小隐腘静脉交界处（SPJ）时，它不如双功超声扫描（DUS）准确。
本研究的目的是比较CWD与DUS在SPJ处的检查结果，并评估腘静脉功能不全对CWD准确性的影响。
对连续到静脉诊所就诊、需要对其SPJ进行双功扫描的患者进行前瞻性研究。每位患者由一名外科医生使用CWD检查，由一名放射科医生使用DUS检查。每位观察者都不知道对方的检查结果。还记录了DUS上有关腘静脉功能的其他信息。
对128例静脉曲张患者的约171条肢体进行了研究。CWD检查显示116条肢体的SPJ有反流，而55条肢体没有。患者的平均年龄为54岁（范围18 - 85岁）。男女比例为3:1。CWD与DUS之间的Spearman等级相关性为0.49（p = 0.0001）。CWD的敏感性为92%，特异性为53%（阳性预测值=62%，阴性预测值=89%，准确性=70%）。29条肢体的腘静脉功能不全（IPV）。其中，12条肢体在SPJ处CWD检查显示功能不全而DUS检查显示功能正常，这占出现这些检查结果的肢体总数（n = 43）的28%。
CWD在检测SPJ功能不全方面具有敏感性，但其特异性较低。在本研究中，所有患者中有17%（n = 29）存在腘静脉功能不全。在CWD检查显示SPJ功能不全（多普勒 +）而DUS检查显示功能正常（双功 -）的患者中，高达25%（n = 12）存在潜在的腘静脉功能不全，这可能解释了其特异性较低的原因。在手术前，应通过DUS确认CWD检查显示的SPJ功能不全。
