Durmaz Mehmet Sedat, Arslan Serdar, Baysal Ahmet Nihat, Durmaz Funda Gökgöz, Sivri Mesut, Cebeci Hakan, Tolu İsmet
Departments of Radiology and.
Cardiovascular Surgery, Teaching and Research Hospital, Konya Health Sciences University.
Ultrasound Q. 2018 Sep;34(3):176-182. doi: 10.1097/RUQ.0000000000000356.
We investigated the effectiveness of shear wave elastography (SWE) in patients with lower extremity superficial venous insufficiency (VI). A total of 138 symptomatic patients, 51 asymptomatic volunteers, and a total of 359 lower extremities (257 symptomatic, 102 asymptomatic) were examined. All participants underwent Doppler ultrasound (US) evaluation to determine VI and SWE measurements performed by manually drawing vein wall and perivenous tissue with free region of interest at the great saphenous vein (GSV) and small saphenous vein (SSV). The GSV, SSV diameter, VI, and volume flow of reflux were compared with the SWE values. The SWE values of the symptomatic group for GSV and SSV were significantly higher than those of the asymptomatic control group regardless of whether VI was detected by Doppler US (P < 0.001). There was a statistically significant increase in SWE values for the symptomatic group who were diagnosed as having reflux in GSV and SSV (P < 0.001). A significant positive correlation between increased GSV, SSV diameter, and SWE values was seen (P < 0.001). Venous insufficiency can be diagnosed with a 84.7% sensitivity and 84.2% specificity when 2655 m/s was designated as cutoff value, and with a 85.4% sensitivity and 84.2% specificity when 22,350 kPa was designated as the cutoff value in GSV. Venous insufficiency can be diagnosed with a 84.3% sensitivity and 82.4% specificity when 2845 m/s was designated as cutoff value, and with a 85.7% sensitivity and 84.4% specificity when 27,100 kPa was designated as the cutoff value in SSV. Shear wave elastography may be used effectively in addition to conventional Doppler US examination in diagnosing and following VI.
我们研究了剪切波弹性成像（SWE）在下肢浅静脉功能不全（VI）患者中的有效性。共检查了138例有症状的患者、51例无症状志愿者以及总共359条下肢（257条有症状，102条无症状）。所有参与者均接受了多普勒超声（US）评估以确定VI，并通过在大隐静脉（GSV）和小隐静脉（SSV）处手动绘制静脉壁和静脉周围组织并设置感兴趣的自由区域来进行SWE测量。将GSV、SSV的直径、VI和反流的体积流量与SWE值进行比较。无论多普勒US是否检测到VI，有症状组GSV和SSV的SWE值均显著高于无症状对照组（P<0.001）。在GSV和SSV中被诊断为有反流的有症状组，其SWE值有统计学意义的升高（P<0.001）。观察到GSV、SSV直径增加与SWE值之间存在显著正相关（P<0.001）。当将2655m/s指定为临界值时，诊断静脉功能不全的灵敏度为84.7%，特异度为84.2%；当将22350kPa指定为GSV的临界值时，灵敏度为85.4%，特异度为84.2%。当将2845m/s指定为临界值时，诊断静脉功能不全的灵敏度为84.3%，特异度为82.4%；当将27100kPa指定为SSV的临界值时，灵敏度为85.7%，特异度为84.4%。除了传统的多普勒US检查外，剪切波弹性成像在诊断和随访VI方面可能会得到有效应用。
