Jensen Corey T, Chahin Antoun, Amin Veral D, Khalaf Ahmed M, Elsayes Khaled M, Wagner-Bartak Nicolaus, Zhao Bo, Zhou Shouhao, Bedi Deepak G
Departments of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Departments of Diagnostic Radiology, Baylor College of Medicine, Houston, Texas, USA.
J Ultrasound Med. 2017 Sep;36(9):1867-1874. doi: 10.1002/jum.14220. Epub 2017 May 4.
To determine whether the qualitative sonographic appearance of slow deep venous flow in the lower extremities correlates with quantitative slow flow and an increased risk of deep venous thrombosis (DVT) in oncology patients.
In this Institutional Review Board-approved retrospective study, we reviewed lower extremity venous Doppler sonographic examinations of 975 consecutive patients: 482 with slow flow and 493 with normal flow. The subjective slow venous flow and absence of initial DVT were confirmed by 2 radiologists. Peak velocities were recorded at 3 levels. Each patient was followed for DVT development. The associations between DVT and the presence of slow venous flow were examined by the Fisher exact test; a 2-sample t test was used for peak velocity and DVT group comparisons. The optimal cutoff peak velocity for correlation with the radiologists' perceived slow flow was determined by the Youden index.
Deep venous thrombosis development in the slow-flow group (21 of 482 [4.36%]) was almost doubled compared with patients who had normal flow (11 of 493 [2.23%]; P = .0456). Measured peak venous velocities were lower in the slow-venous flow group (P < .001). Patients with subsequent DVT did not have a significant difference in venous velocities compared with their respective patient groups. The sum of 3 venous level velocities resulted in the best cutoff for dichotomizing groups into normal versus slow venous flow.
Qualitative slow venous flow in the lower extremities on Doppler sonography accurately correlates with quantitatively slower flow, and this preliminary evaluation suggests an associated mildly increased rate of subsequent DVT development in oncology patients.
确定下肢静脉超声定性显示的缓慢血流是否与定量的缓慢血流相关，以及是否与肿瘤患者深静脉血栓形成（DVT）风险增加相关。
在这项经机构审查委员会批准的回顾性研究中，我们回顾了975例连续患者的下肢静脉多普勒超声检查结果：482例血流缓慢患者和493例血流正常患者。两名放射科医生确认了主观的静脉血流缓慢及初始DVT的不存在。在三个水平记录峰值流速。对每位患者进行DVT发生情况的随访。通过Fisher精确检验检查DVT与静脉血流缓慢之间的关联；使用两样本t检验进行峰值流速与DVT组的比较。通过约登指数确定与放射科医生所感知的缓慢血流相关的最佳截止峰值流速。
血流缓慢组的深静脉血栓形成发生率（482例中的21例[4.36%]）几乎是血流正常患者（493例中的11例[2.23%]）的两倍（P = 0.0456）。血流缓慢组的测量峰值静脉流速较低（P < 0.001）。与各自患者组相比，后续发生DVT的患者静脉流速无显著差异。三个静脉水平流速之和产生了将组分为正常与缓慢静脉血流的最佳截止值。
多普勒超声显示的下肢定性静脉血流缓慢与定量的较慢血流准确相关，并且这项初步评估表明肿瘤患者后续DVT发生率有轻度升高。
