Radiology Clinic, VKV Amerikan Hospital, Istanbul, Turkey.
Department of Radiology, Marmara University School of Medicine, Istanbul, Turkey.
Curr Med Imaging. 2021;17(7):897-903. doi: 10.2174/1573405617666210507122819.
Greater Saphenous Vein (GSV) courses within saphenous compartment, an adipose-filled space bound by fasciae provides structural support. Ultrasound Shear-Wave Elastography (SWE) provides objective and quantitative data on tissue shear elasticity modulus.
This study aims to analyze possible associations between early stage GSV insufficiency and saphenous intracompartmental SWE measurements.
Two-hundred consecutive patients, ages 22 to 81 (mean=44.3) years, with venous insufficiency symptoms underwent Doppler and SWE examinations. Patients had no visible or palpable sign of venous disease or had telangiectasia and reticular veins only. Analyses regarding patient age, gender, presence of venous insufficiency of GSV proper and intracompartmental connective tissue elasticity were performed.
Ninety-six patients had Doppler evidence for either bilateral or unilateral insufficiency of GSV proper at mid-thigh level. Intracompartmental elasticity of patients with venous insufficiency (mean=4.36±2.24 kilopascals; range 1.55 to 10.44 kPa) did not differ significantly from those with normal veins (mean=4.82±2.61 kPa; range 2.20 to 12.65 kPa) (p=0.231). No threshold for predicting the presence of venous insufficiency could be determined. Neither were there any correlations between age, gender and intracompartmental elasticity. In patients with unilateral insufficiency, however, elastography values around insufficient veins were significantly lower compared to contralateral normal GSV (p<0.001).
Many intrinsic and patient factors affect intracompartmental connective tissue elastography measurements; thus, cut-off values obtained from specific populations have limited generalizability. Nevertheless, statistically significant intrapatient differences of intracompartmental elasticity among diseased and normal saphenous veins indicate that lack of elastic support from surrounding connective tissues contributes to venous insufficiency in early stages.
大隐静脉（GSV）在富含脂肪的筋膜所围成的隐静脉腔中走行，为其提供结构支撑。超声剪切波弹性成像（SWE）为组织剪切弹性模量提供客观、定量的数据。
本研究旨在分析早期 GSV 功能不全与隐静脉腔内 SWE 测量值之间的可能关联。
200 例连续患者，年龄 22 至 81 岁（平均年龄 44.3 岁），有静脉功能不全症状，行多普勒和 SWE 检查。患者无可见或可触及的静脉疾病迹象，仅有毛细血管扩张和网状静脉。分析了患者年龄、性别、大隐静脉干和腔内结缔组织弹性的静脉功能不全情况。
96 例患者在大腿中段有双侧或单侧大隐静脉干功能不全的多普勒证据。静脉功能不全患者（平均 4.36±2.24kPa；范围 1.55 至 10.44kPa）的腔内弹性与正常静脉患者（平均 4.82±2.61kPa；范围 2.20 至 12.65kPa）无显著差异（p=0.231）。无法确定预测静脉功能不全存在的阈值。年龄、性别与腔内弹性之间也没有相关性。然而，在单侧功能不全的患者中，与对侧正常 GSV 相比，异常静脉周围的弹性成像值明显较低（p<0.001）。
许多内在和患者因素影响腔内结缔组织弹性成像测量值；因此，从特定人群中获得的截止值具有有限的通用性。然而，病变和正常隐静脉之间腔内弹性的患者内统计学显著差异表明，周围结缔组织缺乏弹性支持导致早期静脉功能不全。
