经髂静脉支架置入术后支架狭窄的多普勒超声及超声造影检测。
Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting.
机构信息
Department of Vascular Surgery, the First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Department of Ultrasound, the First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
出版信息
BMC Cardiovasc Disord. 2021 Jan 20;21(1):42. doi: 10.1186/s12872-020-01840-3.
BACKGROUND
To compare the diagnostic accuracy of Doppler ultrasound (DUS) with contrast-enhanced ultrasound (CEUS) for detection of iliac vein stent stenosis using multidetector computed tomography venography (MDCTV) as the reference method.
METHODS
Patients with iliac vein obstructive disease treated with nitinol stents (Smart Control, Cordis, USA) between January 2016 and December 2017 were consecutively included in this study. DUS, CEUS, and MDCTV were carried out in all patients within one week of each other at 1 year post stenting to investigate the presence of stent compression and in-stent restenosis (ISR).
RESULTS
The study included 139 patients (87 females; mean age 58 ± 15 years). For detecting stent compression, the kappa coefficient between the ultrasound modality of gray-scale imaging and MDCTV was 0.901, indicating very good agreement between these two modalities. ISR was detected in 50, 61, and 65 patients by DUS, CEUS, and MDCTV, respectively. DUS and CEUS (kappa = 0.449) and DUS and MDCTV (kappa = 0.516) had moderate agreement for ISR diagnosis, while for which CEUS and MDCTV (kappa 0.884) had very good agreement. The sensitivity and specificity of DUS and CEUS for diagnosing ISR were 63.1% and 90.8%, 87.8% and 97.3%, respectively.
CONCLUSIONS
CEUS is probably superior to DUS in terms of diagnostic accuracy for the follow-up of patients with iliac vein stent stenosis.
背景
比较多普勒超声（DUS）与超声造影（CEUS）检测髂静脉支架狭窄的诊断准确性，以多排螺旋 CT 静脉造影（MDCTV）作为参考方法。
方法
本研究连续纳入 2016 年 1 月至 2017 年 12 月期间接受镍钛合金支架（美国 Cordis 的 Smart Control）治疗的髂静脉阻塞性疾病患者。所有患者均在支架置入后 1 年内，于 1 周内分别接受 DUS、CEUS 和 MDCTV 检查，以评估支架压迫和支架内再狭窄（ISR）的情况。
结果
本研究共纳入 139 例患者（87 例女性；平均年龄 58±15 岁）。对于检测支架压迫，灰阶成像与 MDCTV 之间的超声模态的 κ 系数为 0.901，表明这两种模态之间具有非常好的一致性。DUS、CEUS 和 MDCTV 分别在 50、61 和 65 例患者中检测到 ISR。DUS 和 CEUS（κ=0.449）以及 DUS 和 MDCTV（κ=0.516）对 ISR 诊断具有中等一致性，而 CEUS 和 MDCTV （κ=0.884）具有很好的一致性。DUS 和 CEUS 诊断 ISR 的敏感性和特异性分别为 63.1%和 90.8%、87.8%和 97.3%。
结论
CEUS 可能优于 DUS，在诊断髂静脉支架狭窄患者的随访方面具有更高的准确性。
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