腹股沟处大隐静脉管腔宽度及隐股静脉交界处显著反流的发生情况。

Width of the great saphenous vein lumen in the groin and occurrence of significant reflux in the sapheno-femoral junction.

作者信息

Musil Dalibor, Herman Jiri, Mazuch Julius

机构信息

Vascular Ambulance and Department of Pathophysiology, Palacky University Olomouc, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2008 Dec;152(2):267-70. doi: 10.5507/bp.2008.041.

DOI:10.5507/bp.2008.041

PMID:19219218

Abstract

AIM

This study was performed to assess the contribution of the width of the anechogenous lumen of the great saphenous vein (GSV) in the groin measured by ultrasound (US) to the diagnostics of haemodynamically significant reflux (HSR) in the sapheno-femoral junction (SFJ).

METHODS

We examined 200 lower limbs with primary varicose veins in 182 patients. Duplex scanning was performed with the patients in the supine position. Longitudinally imaging (B-mode) the inner anechogenous diameter of GSV was measured 4-5 cm distal to SFJ. PW Doppler sampling volume was placed at the same distance. The reflux was elicited by Valsalva manoeuvre. The HSR was defined as a backflow lasting > or = 1 s with a velocity of Vmax > or = 10 cm/s.

RESULTS

The mean width of the GSV with HSR (n=152) was 6.39 mm, median 6.0 mm, SD +/- 2.21 mm. The mean width of GSV without HSR (n = 48) was 4.41 mm, median 4.4 mm, SD +/- 0.96 mm. The difference between the mean widths of GSV was statistically significant (p < 0.01). In GSV < 5 mm (n = 77) HSR (V max > or = 10 cm/s) was confirmed in 46 cases (59.7 %), in GSV > or = 5 mm (n = 123) in 106 cases (86.2 %). The sensitivity of dilatation of GSV > or = 5 mm for the presence of HSR in SFJ was 69.7 %, specificity 64.6 %. PPV (positive predictive value) of dilatation of GSV > or = 5 mm for the presence of HSR in SFJ was 86.2 %, NPV (negative predictive value) was 40.3 %, and the diagnostic accuracy of dilatation of GSV > or = 5 mm was 68.5 %.

CONCLUSIONS

Measurement of anechogenous lumen GSV under the groin in B-mode is less sensitive (69.7 %) and less specific (64.6 %) in the diagnostics of HSR in SFJ. Only 68.5 % of all measurements of the width of the GSV below the groin in B-mode provided accurate indirect assessment of the functions of valves in SFJ. US scanning of the width of anechogenous lumen of GSV below the groin may serve only for ancillary examination.

摘要

目的

本研究旨在评估通过超声（US）测量的腹股沟处大隐静脉（GSV）无回声管腔宽度对诊断隐股静脉交界处（SFJ）血流动力学显著反流（HSR）的贡献。

方法

我们检查了182例患者的200条患有原发性静脉曲张的下肢。患者仰卧位进行双功扫描。在纵向上成像（B超模式），于SFJ远端4 - 5 cm处测量GSV的内无回声直径。将PW多普勒取样容积置于相同距离处。通过瓦尔萨尔瓦动作引发反流。HSR定义为反流持续时间≥1秒且Vmax速度≥10 cm/s。

结果

存在HSR的GSV（n = 152）平均宽度为6.39 mm，中位数为6.0 mm，标准差±2.21 mm。不存在HSR的GSV（n = 48）平均宽度为4.41 mm，中位数为4.4 mm，标准差±0.96 mm。GSV平均宽度之间的差异具有统计学意义（p < 0.01）。在GSV < 5 mm（n = 77）的患者中，46例（59.7%）证实存在HSR（Vmax≥10 cm/s）；在GSV≥5 mm（n = 123）的患者中，106例（86.2%）证实存在HSR。GSV扩张至≥5 mm对SFJ处存在HSR的敏感性为69.7%，特异性为64.6%。GSV扩张至≥5 mm对SFJ处存在HSR的阳性预测值（PPV）为86.2%，阴性预测值（NPV）为40.3%，GSV扩张至≥5 mm的诊断准确性为68.5%。