Alimi Y S, Accrocca F, Barthèlemy P, Hartung O, Dubuc M, Boufi M
Department of Vascular Surgery, University Hôpital Nord, Chemin des Bourrelly, 13915 Marseilles Cedex 20, France.
Eur J Vasc Endovasc Surg. 2004 Nov;28(5):513-9. doi: 10.1016/j.ejvs.2004.08.008.
Review of a 10 year-experience, to evaluate the efficacy of pre-operative investigations in the detection of external iliac artery (EIA) endofibrosis in top endurance athletes.
Retrospective study.
From September 1995 to March 2004, 13 highly-trained athletes (all men, mean age 32.3 years) underwent surgery for disease involving 14 lower limbs (11 left, one right, one bilateral).
We compared ultrasound scan (US) and digital subtraction angiography (DSA) data, at rest and at hip flexion with intra-operative findings for all 14 lower limbs. We analyzed the presence of stenosis in the external and common iliac arteries, the presence of psoas muscle arteries and the presence of excessive EIA length.
In the affected limbs, before treatment, the mean ankle brachial index (ABI) at rest was 0.98 compared with 0.56 after exercise, p=0.0001. The sensitivities of the US vs DSA examination in the detection of external and common iliac artery stenosis were, respectively, 84.6 and 53.8% vs 53.8 and 12.5%. The muscle psoas artery was detected by DSA with a sensitivity of 57.1 and 100% specificity. For the detection of excessive EIA length, the sensitivity of US was 85.7% with 57.1% specificity.
A fall of ABI after exercise proves the presence of a significant stenosis in symptomatic athletes. Color coded duplex ultrasonography is recommended for non-invasive imaging of suspected endofibrotic stenosis in young athletes, since it detects reliably both stenosis and elongation of iliacal arteries.
回顾10年经验，评估术前检查在检测顶级耐力运动员髂外动脉（EIA）内膜纤维化方面的有效性。
回顾性研究。
1995年9月至2004年3月，13名训练有素的运动员（均为男性，平均年龄32.3岁）因涉及14条下肢（11条左侧、1条右侧、1条双侧）的疾病接受手术。
我们将所有14条下肢在静息和髋关节屈曲时的超声扫描（US）和数字减影血管造影（DSA）数据与术中发现进行比较。我们分析了髂外动脉和髂总动脉狭窄的存在情况、腰大肌动脉的存在情况以及EIA过长的情况。
在患侧肢体中，治疗前静息时平均踝臂指数（ABI）为0.98，运动后为0.56，p = 0.0001。在检测髂外动脉和髂总动脉狭窄方面，US检查与DSA检查的敏感性分别为84.6%和53.8%以及53.8%和12.5%。DSA检测腰大肌动脉的敏感性为57.1%，特异性为100%。对于检测EIA过长，US的敏感性为85.7%，特异性为57.1%。
运动后ABI下降证明有症状的运动员存在明显狭窄。对于年轻运动员疑似内膜纤维化狭窄的无创成像，建议使用彩色编码双功超声检查，因为它能可靠地检测髂动脉的狭窄和延长。
