Baxter G M, Kincaid W, Jeffrey R F, Millar G M, Porteous C, Morley P
Department of Radiology, Western Infirmary, Glasgow, UK.
Br J Radiol. 1991 Sep;64(765):777-81. doi: 10.1259/0007-1285-64-765-777.
The primary imaging technique in suspected venous occlusive disease has for many years been contrast venography. Recent studies have shown ultrasound with the addition of colour Doppler imaging to be a suitable alternative method in the diagnosis of lower limb venous thrombosis. We have applied these techniques to the upper limb venous system, and have performed a prospective study of 19 patients (30 limbs) comparing colour Doppler ultrasound with venography in the diagnosis of axillary and subclavian vein thrombosis, for which colour Doppler ultrasound has a sensitivity and specificity of 100%. If vein stenosis is included, the sensitivity falls to 89%. We propose that colour Doppler ultrasound is a suitable first-line alternative to venography in the diagnosis of axillary and subclavian vein thrombosis. In addition to showing the major venous drainage of the upper limb, ultrasound routinely assesses patency of the internal jugular vein, which is, on occasion, of clinical relevance when determining possible future sites of venous access. If, however, colour Doppler ultrasound is normal then bilateral upper limb venography is indicated to exclude a more central venous problem or localized stenotic lesion.
多年来，怀疑有静脉闭塞性疾病时的主要成像技术一直是静脉造影。最近的研究表明，超声加上彩色多普勒成像在诊断下肢静脉血栓形成方面是一种合适的替代方法。我们已将这些技术应用于上肢静脉系统，并对19例患者（30条肢体）进行了一项前瞻性研究，比较彩色多普勒超声与静脉造影在诊断腋静脉和锁骨下静脉血栓形成中的作用，彩色多普勒超声对此的敏感性和特异性为100%。若将静脉狭窄包括在内，敏感性则降至89%。我们认为，彩色多普勒超声在诊断腋静脉和锁骨下静脉血栓形成方面是静脉造影合适的一线替代方法。超声除了显示上肢的主要静脉引流外，还常规评估颈内静脉的通畅情况，在确定未来可能的静脉穿刺部位时，这有时具有临床意义。然而，如果彩色多普勒超声检查结果正常，则需进行双侧上肢静脉造影以排除更中心部位的静脉问题或局限性狭窄病变。
