Savy-Stortz C, Nové-Josserand R, Dubost A, Durand D V, Levrat R
Service de Médecine interne et Angiologie, Centre Hospitalier Lyon-Sud, Pierre Bénite.
Presse Med. 1995 Feb 18;24(7):341-4.
A prospective study of deep vein thrombosis was conducted to compare diagnosis with venous echo-Doppler and phlebography in 101 hospitalized patients with symptomatic lower limbs.
Phlebography was used as the reference examination to evaluate the sensitivity and specificity of echo-Doppler for lesions at all levels of the limb.
Overall sensitivity was 90% and specificity 72%. The prevalence of venous thrombosis was 50% symptomatic patients and the positive predictive value of echo-Doppler was 76%. The negative predictive value was 88%. For patients with proximal signs, there were no false negatives with echo-Doppler and for those with distal signs, particularly in patients who had recently undergone surgery, were obese or had a past history of deep vein thrombosis echo-Doppler gave less satisfactory results.
Echo-Doppler can be proposed as a first intention examination for the search for deep vein thrombosis in patients with clinical signs in the proximal area of the leg, while phlebography is still required for more distal areas.
对101例有症状的下肢住院患者进行深静脉血栓形成的前瞻性研究,比较静脉超声多普勒检查和静脉造影术的诊断效果。
以静脉造影术作为参考检查,评估超声多普勒对肢体各部位病变的敏感性和特异性。
总体敏感性为90%,特异性为72%。有症状患者中静脉血栓形成的患病率为50%,超声多普勒的阳性预测值为76%。阴性预测值为88%。对于有近端体征的患者,超声多普勒检查无假阴性结果;而对于有远端体征的患者,尤其是近期接受过手术、肥胖或有深静脉血栓形成病史的患者,超声多普勒检查结果不太理想。
对于有腿部近端临床体征的患者,超声多普勒可作为筛查深静脉血栓形成的首选检查方法,而对于更远端部位仍需要进行静脉造影术检查。