Kalodiki E, Nicolaides A N, al-Kutoubi A, Cunningham D A, Crofton M
Irvine Laboratory for Cardiovascular Investigation and Research, St. Mary's Hospital, London, United Kingdom.
J Arthroplasty. 1997 Apr;12(3):310-6. doi: 10.1016/s0883-5403(97)90028-0.
Color flow duplex imaging is a well-established method for the diagnosis of deep vein thrombosis in symptomatic patients; however, the sensitivity and specificity of duplex scanning compared with venography in high-risk asymptomatic patients are not known. Consecutive patients undergoing total hip arthroplasty who consented to have bilateral venography on days 8 to 12 were included in this prospective study. One hundred and fifty-one venograms were finally obtained in 78 patients. All duplex scanning was performed with the Ultramark 9 ATL (Advanced Technology Laboratories) by one investigator. In the beginning of the study, the first 44 legs, only the femoropopliteal segment was tested and the result was based on B-mode compression; the sensitivity for the duplex was 56% (5/9), and the specificity, 94% (33/35). In the next 107 legs, the addition of color to our criteria improved the sensitivity of the duplex scan from 55% to 93% (13/14) for the femoropopliteal segment and the specificity from 94% to 99% (92/93). For the calf segment, in the same 107 legs, using the color facility of the duplex, the sensitivity and specificity were 79% (15/19) and 97% (85/88), respectively. The color facility of new-generation machines makes duplex scanning reliable for the detection of proximal deep vein thrombosis, even in asymptomatic high-risk patients. For the detection of calf deep vein thrombosis, however, more experience is needed. A larger study is necessary to confirm these preliminary data.
彩色血流双功成像对于有症状患者的深静脉血栓诊断是一种成熟的方法；然而，与静脉造影相比，双功扫描在高危无症状患者中的敏感性和特异性尚不清楚。本前瞻性研究纳入了连续接受全髋关节置换术且同意在术后第8至12天进行双侧静脉造影的患者。最终在78例患者中获得了151份静脉造影片。所有双功扫描均由一名研究人员使用Ultramark 9 ATL（先进技术实验室）进行。在研究开始时，对前44条腿，仅检测股腘段，结果基于B超压迫；双功扫描的敏感性为56%（5/9），特异性为94%（33/35）。在接下来的107条腿中，增加彩色血流标准后，股腘段双功扫描的敏感性从55%提高到93%（13/14），特异性从94%提高到99%（92/93）。对于小腿段，在同样的107条腿中，使用双功扫描的彩色血流功能，敏感性和特异性分别为79%（15/19）和97%（85/88）。新一代机器的彩色血流功能使双功扫描即使在无症状高危患者中对于近端深静脉血栓的检测也很可靠。然而，对于小腿深静脉血栓的检测，还需要更多经验。需要进行更大规模的研究来证实这些初步数据。
