Baldassarre Damiano, Pustina Linda, Castelnuovo Samuela, Bondioli Alighiero, Carlà Matteo, Sirtori Cesare R
E. Grossi Paoletti Center, Department of Pharmacological Sciences, University of Milan, Milan, Italy.
Angiology. 2003 Sep-Oct;54(5):541-9. doi: 10.1177/000331970305400503.
The feasibility and reproducibility of a new ultrasonic method for the direct assessment of maximal varicose vein diameter (VVD) were evaluated. A study was also performed to demonstrate the capacity of the method to detect changes in venous diameter induced by a pharmacologic treatment. Patients with varicose vein disease were recruited. A method that allows the precise positioning of patient and transducer and performance of scans in a gel-bath was developed. Maximal VVD was recorded both in the standing and supine positions. The intraassay reproducibility was determined by replicate scans made within 15 minutes in both positions. The interobserver variability was assessed by comparing VVDs measured during the first phase baseline examination with those obtained during baseline examinations in the second phase of the study. The error in reproducibility of VVD determinations was 5.3% when diameters were evaluated in the standing position and 6.4% when assessed in the supine position. The intramethod agreement was high, with a bias between readings of 0.06 +/- 0.18 mm and of -0.02 +/- 0.19 mm, respectively, in standing and supine positions. Correlation coefficients were better than 0.99 in both positions. The method appears to be sensitive enough to detect small changes in VVDs induced by treatments. The proposed technique provides a tool of potential valid use in the detection and in vivo monitoring of VVD changes in patients with varicose vein disease. The method offers an innovative approach to obtain a quantitative assessment of varicose vein progression and of treatment effects, thus providing a basis for epidemiologic surveys.
对一种直接评估最大静脉曲张直径（VVD）的新型超声方法的可行性和可重复性进行了评估。还开展了一项研究，以证明该方法检测药物治疗引起的静脉直径变化的能力。招募了患有静脉曲张疾病的患者。开发了一种能使患者和换能器精确定位并在凝胶浴中进行扫描的方法。在站立位和仰卧位均记录最大VVD。通过在两个体位15分钟内进行重复扫描来确定测定内的可重复性。通过比较研究第一阶段基线检查期间测量的VVD与研究第二阶段基线检查期间获得的VVD来评估观察者间的变异性。当在站立位评估直径时，VVD测定的可重复性误差为5.3%，在仰卧位评估时为6.4%。方法内一致性较高，站立位和仰卧位读数之间的偏差分别为0.06±0.18mm和-0.02±0.19mm。两个体位的相关系数均优于0.99。该方法似乎足够灵敏，能够检测治疗引起的VVD微小变化。所提出的技术为检测和体内监测静脉曲张疾病患者的VVD变化提供了一种可能有效使用的工具。该方法提供了一种创新方法，可对静脉曲张进展和治疗效果进行定量评估，从而为流行病学调查提供依据。
