Krünes U, Teubner K, Knipp H, Holzapfel R
Gemeinschaftspraxis Klinik Oberwald, Grebenhain, Germany.
Vasa. 1998 Aug;27(3):172-5.
Thrombosis of the soleal and gastrocnemial veins seldom receive very much attention. It is thought that they are frequently the starting point for deep vein thrombosis of the lower extremity.
125 patients with clinically suspected deep vein thrombosis of the leg were examined by means of duplex sonography and phlebography. The ultrasound examination was performed on the lower limb in the form of a compression sonography.
From 137 legs examined, a total of 82 cases of deep vein thrombosis were diagnosed. Sonographically and/or phlebographically, the soleal and/or gastrocnemial veins were found to be involved in 65 cases of thrombosis, i.e. 79% of all thrombosis. 25% of all cases of deep vein thrombosis of the leg were isolated muscular vein thrombosis. Pain in the calf while walking, similar to muscular soreness after exertion, was typical of the isolated muscular vein thrombosis. The muscular veins were involved in all the deep vein thrombosis of the leg of the 3- and 4-layer type. Diagnosis of soleal and gastrocnemial vein thrombosis is quite possible by means of sonography and phlebography. The sensitivity and specificity of the compression sonography were 88% and 95% respectively, compared to the phlebography.
In patients suffering from pain in the calf, the soleal and gastrocnemial veins should be carefully included in the sonographic or phlebographic assessment. Due to the risk of deep vein thrombosis, isolated muscular vein thrombosis should receive treatment appropriate for a deep vein thrombosis of the calf, and its development be checked.
比目鱼肌静脉和腓肠肌静脉血栓形成很少受到太多关注。人们认为它们常常是下肢深静脉血栓形成的起始点。
对125例临床怀疑腿部深静脉血栓形成的患者采用双功超声检查和静脉造影进行检查。超声检查以压迫超声的形式对下肢进行。
在检查的137条腿中，共诊断出82例深静脉血栓形成。在超声检查和/或静脉造影检查中，发现65例血栓形成累及比目鱼肌静脉和/或腓肠肌静脉，即占所有血栓形成的79%。腿部所有深静脉血栓形成病例中有25%为孤立性肌静脉血栓形成。行走时小腿疼痛，类似于运动后的肌肉酸痛，是孤立性肌静脉血栓形成的典型表现。在所有3层和4层类型的腿部深静脉血栓形成中均累及肌静脉。通过超声检查和静脉造影很有可能诊断比目鱼肌静脉和腓肠肌静脉血栓形成。与静脉造影相比，压迫超声检查的敏感性和特异性分别为88%和95%。
对于小腿疼痛的患者，在超声或静脉造影评估中应仔细检查比目鱼肌静脉和腓肠肌静脉。由于存在深静脉血栓形成的风险，孤立性肌静脉血栓形成应接受适合小腿深静脉血栓形成的治疗，并对其发展情况进行监测。
