McClusky D, Rosenthal D, Stanton P E, Lamis P A
South Med J. 1980 Jan;73(1):43-4. doi: 10.1097/00007611-198001000-00017.
To evaluate the diagnostic accuracy of Doppler ultrasound (DU) and impedance plethysmography (IPG) in deep vein thrombosis (DVT), hospital records of 904 patients having 1,084 studies of blood flow in the lower extremities were retrospectively reviewed, and 544 were found abnormal. In 128, both DU and IPG showed abnormalities, 86 had only DU evidence of abnormalities, and 330 had only IPG abnormalities. Fifty-one patients with abnormal results of both DU and IPG studies had ascending phlebography, which in 47 documented the presence of DVT, for a diagnostic accuracy of 92%. On the basis of DU/IPG testing, or extenuating clinical circumstances, 135 patients considered at high risk for pulmonary emboli had ventilation-perfusion lung scans. Of these, 44 had roentgenographic evidence of pulmonary emboli. While ascending phlebography remains the definitive study for documenting the presence of DVT, DU/IPG testing has a high accuracy rate, is noninvasive, readily reproducible, inexpensive, and simple to perform. When results of DU/IPG studies are abnormal a baseline ventilation lung scan should be done which, if questionable, should be followed by pulmonary arteriography.
为评估多普勒超声（DU）和阻抗体积描记法（IPG）对深静脉血栓形成（DVT）的诊断准确性，我们回顾性分析了904例患者的1084次下肢血流检查的医院记录，发现其中544例异常。128例患者中，DU和IPG均显示异常；86例仅有DU异常证据；330例仅有IPG异常。51例DU和IPG检查结果均异常的患者接受了上行静脉造影，其中47例证实存在DVT，诊断准确性为92%。基于DU/IPG检测结果或特殊临床情况，135例被认为有肺栓塞高风险的患者接受了通气-灌注肺扫描。其中，44例有肺栓塞的影像学证据。虽然上行静脉造影仍然是确诊DVT的决定性检查，但DU/IPG检测具有较高的准确率，无创、易于重复、价格低廉且操作简单。当DU/IPG检查结果异常时，应进行基线通气肺扫描，如有疑问，应进一步行肺动脉造影。
