Haire W D, Lynch T G, Lund G B, Lieberman R P, Edney J A
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68105.
J Vasc Surg. 1991 Mar;13(3):391-7. doi: 10.1067/mva.1991.25130.
To investigate the potential role of magnetic resonance imaging and duplex scanning in the diagnosis of catheter-induced subclavian vein thrombosis, we correlated the results of 43 arm phlebograms with duplex scans; 28 of these phlebograms were also correlated with magnetic resonance imaging scans of the thoracic veins. Eighteen of the 43 phlebograms were normal, and all had normal magnetic resonance imaging and duplex studies. Eleven subclavian veins were totally occluded on phlebography; all had duplex scans, and five were also scanned with magnetic resonance imaging. Duplex scans detected 6 of 11 occlusions, whereas magnetic resonance imaging detected 4 of the 5 occlusions scanned. The five occlusions that were not detected by either magnetic resonance imaging or duplex scans were short segmental occlusions of the medial one third of the left subclavian vein. Of 14 nonocclusive thrombi seen on phlebography, duplex scans correctly identified 8. Magnetic resonance imaging was done on eight nonocclusive thrombi but identified only two. All abnormal findings on duplex scanning and magnetic resonance imaging were confirmed by phlebography. Short occlusions of the proximal portion of the left subclavian vein were often undetected by duplex scanning but occasionally seen with magnetic resonance imaging. Neither modality was sensitive to the presence of nonocclusive mural thrombi. Magnetic resonance imaging is highly reliable in ruling out the presence of a thrombotic process in the subclavian vein, but it may on occasion fail to detect the presence of subclavian thrombi. For this reason, in cases with suspected subclavian vein thrombosis magnetic resonance imaging cannot be used as the only diagnostic modality.(ABSTRACT TRUNCATED AT 250 WORDS)
为了研究磁共振成像和双功扫描在诊断导管相关性锁骨下静脉血栓形成中的潜在作用，我们将43例上肢静脉造影结果与双功扫描结果进行了对比；其中28例静脉造影还与胸部静脉的磁共振成像扫描结果进行了对比。43例静脉造影中有18例正常，所有这些病例的磁共振成像和双功扫描检查结果均正常。11例锁骨下静脉在静脉造影时完全闭塞；所有病例均进行了双功扫描，其中5例还进行了磁共振成像扫描。双功扫描检测出11例闭塞中的6例，而磁共振成像检测出所扫描的5例闭塞中的4例。磁共振成像和双功扫描均未检测到的5例闭塞是左锁骨下静脉内侧三分之一处的短节段闭塞。在静脉造影中发现的14例非闭塞性血栓中，双功扫描正确识别出8例。对8例非闭塞性血栓进行了磁共振成像检查，但仅识别出2例。双功扫描和磁共振成像的所有异常发现均经静脉造影证实。左锁骨下静脉近端的短闭塞常常不能被双功扫描检测到，但偶尔可被磁共振成像发现。两种检查方法对非闭塞性壁血栓的存在均不敏感。磁共振成像在排除锁骨下静脉血栓形成过程方面高度可靠，但偶尔可能无法检测到锁骨下血栓的存在。因此，在怀疑有锁骨下静脉血栓形成的病例中，磁共振成像不能作为唯一的诊断方法。（摘要截短至250字）
