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妊娠期疑似静脉血栓栓塞性疾病的诊断

Diagnosis of suspected venous thromboembolic disease in pregnancy.

作者信息

Scarsbrook A F, Evans A L, Owen A R, Gleeson F V

机构信息

Department of Radiology, Churchill Hospital, Oxford Radcliffe NHS Trust, Headington, Oxford, UK.

出版信息

Clin Radiol. 2006 Jan;61(1):1-12. doi: 10.1016/j.crad.2005.08.015.

Abstract

Venous thromboembolic disease is a leading cause of maternal mortality during pregnancy. Early and accurate radiological diagnosis is essential as anticoagulation is not without risk and clinical diagnosis is unreliable. Although the disorder is potentially treatable, unnecessary treatment should be avoided. Most of the diagnostic imaging techniques involve ionizing radiation which exposes both the mother and fetus to finite radiation risks. There is a relative lack of evidence in the literature to guide clinicians and radiologists on the most appropriate method of assessing this group of patients. This article will review the role of imaging of suspected venous thromboembolic disease in pregnant patients, highlight contentious issues such as radiation risk, intravenous contrast use in pregnancy and discuss the published guidelines, as well as suggesting an appropriate imaging algorithm based on the available evidence.

摘要

静脉血栓栓塞性疾病是孕期孕产妇死亡的主要原因。由于抗凝治疗并非毫无风险且临床诊断不可靠,早期准确的影像学诊断至关重要。尽管该疾病具有潜在可治性,但应避免不必要的治疗。大多数诊断性成像技术涉及电离辐射,这会使母亲和胎儿都面临一定的辐射风险。文献中相对缺乏证据来指导临床医生和放射科医生采用最合适的方法评估这类患者。本文将综述疑似静脉血栓栓塞性疾病的影像学检查在孕妇中的作用,强调诸如辐射风险、孕期使用静脉造影剂等有争议的问题,讨论已发布的指南,并根据现有证据提出合适的成像算法。

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