Department of Angiology, University Hospital Basel, University of Basel, Switzerland.
Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, United States.
Thromb Haemost. 2017 Nov;117(11):2146-2155. doi: 10.1160/TH17-05-0332. Epub 2017 Nov 30.
Inflammatory processes of the venous wall in acute deep vein thrombosis (DVT) play a role in thrombus formation and resolution. However, direct evaluation of the perivascular inflammation is currently not feasible. To assess perivascular perfusion in acute proximal DVT using contrast-enhanced ultrasound (CEUS) reflecting perivenous inflammation and its association with systemic inflammatory markers in a single-centre, prospective observational study. Twenty patients with proximal DVT underwent CEUS imaging in the thrombosed and contralateral popliteal vein at baseline and after 2 weeks and 3 months. Perfusion was quantified by measuring peak enhancement (PE) and wash-in rate (WiR) in a perivenous region after bolus injection of the contrast agent. High-sensitive C-reactive protein (hsCRP) and interleukin-6 (IL-6) were determined at the time of each CEUS imaging. PE and WiR were significantly higher in the thrombosed compared with the unaffected leg at baseline (1,007 vs. 34 au and 103 vs. 4 au/s) and 2-week follow-up (903 vs. 35 au and 70 vs. 4 au/s). Compared with baseline, PE and WiR in the thrombosed leg significantly decreased to 217 au and 18 au/s at 3-month follow-up.At baseline, hsCRP and IL-6 were elevated at 20.1 mg/mL and 8.2 pg/mL and decreased significantly to 2.8 mg/mL and 2.6 pg/mL at 2-week follow-up, remaining low after 3 months. There was a weak association between the level of inflammatory markers and the CEUS parameters at baseline on the thrombosed leg. Elevated perivascular perfusion assessed by CEUS imaging is associated with the inflammatory response in acute DVT.
在急性深静脉血栓形成（DVT）中，静脉壁的炎症过程在血栓形成和溶解中起作用。然而，目前无法直接评估血管周围的炎症。
在一项单中心前瞻性观察研究中，使用对比增强超声（CEUS）评估急性近端 DVT 中的血管周围灌注，反映血管周围炎症，并评估其与全身炎症标志物的相关性。
20 例近端 DVT 患者在基线时、2 周和 3 个月时分别对血栓形成和对侧腘静脉进行 CEUS 成像。在对比剂团注后，通过测量血管周围区域的峰值增强（PE）和流入率（WiR）来量化灌注。在每次 CEUS 成像时，还测定高敏 C 反应蛋白（hsCRP）和白细胞介素 6（IL-6）。
与未受影响的腿相比，基线时和 2 周随访时，血栓形成的腿的 PE 和 WiR 均显著更高（1007 与 34 au 和 103 与 4 au/s）。与基线相比，血栓形成腿的 PE 和 WiR 在 3 个月随访时显著降低至 217 au 和 18 au/s。
在基线时，hsCRP 和 IL-6 分别为 20.1 mg/mL 和 8.2 pg/mL，在 2 周随访时显著降低至 2.8 mg/mL 和 2.6 pg/mL，3 个月后仍较低。在血栓形成腿上，基线时炎症标志物的水平与 CEUS 参数之间存在弱相关性。
CEUS 成像评估的血管周围灌注升高与急性 DVT 中的炎症反应相关。
