Smith Agw, Parker P, Byass O, Chiu K
Department of Academic Radiology, Hull Royal Infirmary, Hull, UK.
Ultrasound. 2016 Feb;24(1):17-22. doi: 10.1177/1742271X15625432. Epub 2016 Jan 19.
Deep vein thrombosis (DVT) is a potentially fatal condition causing significant morbidity and mortality in the patient population. Ultrasound (USS) is the mainstay for detecting DVT. This can sometimes be difficult in hostile limbs due to factors such as large body habitus and oedema. This pilot study investigated contrast-enhanced ultrasound (CEUS) as a viable method to improve visualisation of the venous system of the lower limb.
Patients at high risk for DVT were selected after an initial negative USS. A follow-up scan was performed 1 week later utilising standard B-mode imaging with a curvilinear 3-5 MHz transducer array. After the fundamental scan, intravenous Sonovue™ contrast was administered and visualisation of the proximal limb veins and visualisation gains in distance were mapped onto a proforma.
Twelve patients were selected. Visualisation was not improved in the common femoral vein (CFV) but increases in full visualisation were demonstrated in the femoral vein (FV) and popliteal vein (Pop V) from (n = 8) 67% and (n = 10) 83-100% in both veins, respectively. Significant gains in visualisation distance were observed in the posterior tibial vein (PTV) (p = 0.0005) and peroneal vein (Per V) (p = 0.02) with increased full visualisation of the Per V from (n = 3) 25% to (n = 7) 58%.
CEUS is a viable and clinically safe method for increasing visualisation of the deep venous system. It has the potential to improve visualisation of the lower limb venous system, reducing follow-up costs and diagnostic uncertainty for patients and the clinician.
深静脉血栓形成（DVT）是一种潜在的致命疾病，在患者群体中会导致显著的发病率和死亡率。超声（USS）是检测DVT的主要手段。由于体型庞大和水肿等因素，在条件不佳的肢体中有时难以进行检测。这项初步研究调查了超声造影（CEUS）作为一种可行方法，以改善下肢静脉系统的可视化。
在初次超声检查结果为阴性后，选择DVT高危患者。1周后使用带有3 - 5MHz曲线换能器阵列的标准B模式成像进行随访扫描。在基础扫描后，静脉注射声诺维™造影剂，并将近端肢体静脉的可视化情况及可视化距离增益记录在表格上。
选取了12名患者。股总静脉（CFV）的可视化情况未得到改善，但股静脉（FV）和腘静脉（Pop V）的完全可视化分别从（n = 8）67%和（n = 10）83 - 100%有所增加。胫后静脉（PTV）（p = 0.0005）和腓静脉（Per V）（p = 0.02）的可视化距离有显著增加，腓静脉的完全可视化从（n = 3）25%增加到（n = 7）58%。
超声造影是一种可行且临床安全的增加深静脉系统可视化的方法。它有可能改善下肢静脉系统的可视化，降低患者和临床医生的随访成本及诊断不确定性。
