Paluch Łukasz, Nawrocka-Laskus Ewa, Dąbrowska Agnieszka, Popiela Tadeusz, Walecki Jerzy
Department of Radiology, Gruca Orthopedic and Trauma Teaching Hospital, Center of Postgraduate Medical Education, Otwock, Poland.
Department of Diagnostic Imaging, Injury Center of Emergency Medicine and Disaster, Jagiellonian University, Cracow, Poland.
Pol J Radiol. 2017 Feb 13;82:88-91. doi: 10.12659/PJR.899517. eCollection 2017.
Venous thrombosis is a multicausal disease involving intravenous clot formation. It may occur spontaneously or after provoking events, such as traumatic injuries to the pelvis, upper and lower extermities, immobilization, intravascular procedures, including venous catheterization or injection. Color Doppler ultrasonography is a rapid and non-invasive technique for evaluation of venous disease. It is a very sensitive method for detection of thrombi, but has some limitations, e.g. inability to distinguish between an old and fresh thrombus. Elastography as a method for evaluation of tissue elasticity and allows more accurate assessment of venous thombosis. The thrombus solidifies significantly during the process of remodeling, thereby changing elasticity, while the tissues located around the vessel remain unchanged. Moreover, the homogeneity of the thrombus is also changed. These factors allow for exact determination of the age of the thrombus depending on changes of its elasticity.
MATERIAL/METHODS: The object of this study was to assess thrombus age in patients with saphenous vein insufficiency treated with sclerotherapy. We examined 34 patients, 30 women and 4 men, aged 18-62 years. All short-listed patients with initial 7-8 mm vessel diameter underwent treatment with 3% Aetoxysklerol mixed with CO and other respiratory gases. Data acquisition was performed using an Esaote MyLab Twice device with LA523 linear probe.
On the sixth day after the treatment 31 patients presented uniform, hypoechogenic thrombus in B-mode image. Ultrasound-based elasticity images (elastography) showed significant predominant red and green areas. Blue area was either invisible or appeared in insignificant grade on examined area. The mosaic image of colors appeared on 2 patients. On the fourteenth day of study 21 patients still presented hypoechogenic thrombus, whereas mixed echogenicity of thrombus appeared on 11 patients. On 28 examined patients mosaics of red, green and blue colors were observed, with blue color significantly predominating over red color. 3 patients presented mosaics of colors without a predominate color.
Elastography as a method of thrombus evaluation, provides information about relative shrinkage of blood clot. It seems that elasatography can improve accurate assessment of the exact age of thrombus.
静脉血栓形成是一种涉及静脉内血栓形成的多病因疾病。它可能自发发生，也可能在诱发事件后出现，如骨盆、上肢和下肢的创伤性损伤、制动、血管内操作，包括静脉插管或注射。彩色多普勒超声检查是一种评估静脉疾病的快速、非侵入性技术。它是检测血栓的一种非常敏感的方法，但有一些局限性，例如无法区分陈旧性血栓和新鲜血栓。弹性成像作为一种评估组织弹性的方法，能够更准确地评估静脉血栓形成。在重塑过程中，血栓会显著固化，从而改变弹性，而血管周围的组织保持不变。此外，血栓的均匀性也会改变。这些因素使得根据血栓弹性的变化能够准确确定血栓的形成时间。
材料/方法：本研究的目的是评估接受硬化治疗的大隐静脉功能不全患者的血栓形成时间。我们检查了34例患者，其中30例女性，4例男性，年龄在18至62岁之间。所有入选的初始血管直径为7 - 8毫米的患者接受了3%乙氧硬化醇与一氧化碳和其他呼吸气体混合的治疗。使用配备LA523线性探头的百胜MyLab Twice设备进行数据采集。
治疗后第六天，31例患者在B超图像中呈现均匀的低回声血栓。基于超声的弹性图像（弹性成像）显示显著的主要红色和绿色区域。蓝色区域要么不可见，要么在检查区域以不显著的等级出现。2例患者出现彩色镶嵌图像。在研究的第十四天，21例患者仍呈现低回声血栓，而11例患者的血栓出现混合回声。在28例检查患者中观察到红色、绿色和蓝色的彩色镶嵌，其中蓝色显著多于红色。3例患者出现无主导颜色的彩色镶嵌。
弹性成像作为一种血栓评估方法，提供了有关血凝块相对收缩的信息。似乎弹性成像可以改善对血栓确切形成时间的准确评估。
