Rose S C, Zwiebel W J, Murdock L E, Hofmann A A, Priest D L, Knighton R A, Swindell T M, Lawrence P F, Miller F J
Department of Radiology, University of Utah Medical Center, Salt Lake City 84132.
J Vasc Interv Radiol. 1993 Jan-Feb;4(1):111-7. doi: 10.1016/s1051-0443(93)71832-1.
Although color Doppler flow imaging (CDFI) has been shown to accurately depict calf vein thrombosis in symptomatic patients, this technique has not been proved accurate for detection of calf vein thrombosis in a population restricted to asymptomatic postoperative patients.
To evaluate the accuracy of CDFI in asymptomatic postoperative patients, both CDFI and contrast venography were performed on 78 limbs of 76 patients without symptoms of deep venous thrombosis (DVT) who had undergone either hip or knee replacement. CDFI and venographic examination were interpreted blindly with respect to the results of the other modality or clinical findings. Venography was the standard for comparison of results.
Fifty-six percent of CDFI examinations of the calf vein were technically adequate. The remaining studies were compromised technically by limb swelling and/or obesity. For the technically adequate CDFI studies, calf vein thrombosis was detected in eight of 10 patients. Calculated sensitivity in this cohort was 80%, and specificity was 97%. The sensitivity of CDFI for acute calf DVT in all patients, regardless of image quality, was 42%.
These observations suggest that state-of-the-art CDFI is not an accurate examination for acute calf vein DVT in asymptomatic postoperative patients. CDFI is associated with a high rate of technically compromised studies and relatively low sensitivity in studies that are deemed technically satisfactory. These observations do not preclude the use of CDFI in postoperative patients for detection of thrombus extension into the popliteal vein or for detecting thrombosis of more proximal lower extremity veins.
尽管彩色多普勒血流成像（CDFI）已被证明能准确描绘有症状患者的小腿静脉血栓形成，但该技术在仅限于无症状术后患者的人群中检测小腿静脉血栓形成的准确性尚未得到证实。
为评估CDFI在无症状术后患者中的准确性，对76例接受髋关节或膝关节置换且无深静脉血栓形成（DVT）症状的患者的78条肢体进行了CDFI和静脉造影检查。CDFI和静脉造影检查的解读均对另一种检查方式的结果或临床发现不知情。静脉造影是结果比较的标准。
小腿静脉的CDFI检查中有56%在技术上是充分的。其余检查因肢体肿胀和/或肥胖在技术上受到影响。对于技术上充分的CDFI检查，10例患者中有8例检测到小腿静脉血栓形成。该队列中计算出的敏感性为80%，特异性为97%。无论图像质量如何，所有患者中CDFI对急性小腿DVT的敏感性为42%。
这些观察结果表明，对于无症状术后患者的急性小腿静脉DVT，先进的CDFI检查并不准确。CDFI与技术上受影响的检查率较高以及在技术上令人满意的检查中相对较低的敏感性相关。这些观察结果并不排除在术后患者中使用CDFI来检测血栓延伸至腘静脉或检测更近端下肢静脉的血栓形成。
