Mercer K G, Scott D J, Berridge D C
Department of Vascular, St James's and Seacroft University Hospital NHS Trust, Leeds, UK.
Br J Surg. 1998 Nov;85(11):1495-7. doi: 10.1046/j.1365-2168.1998.00877.x.
Physical examination is unreliable in the detection of sources of reflux in varicose veins. Hand-held Doppler (HHD) ultrasonography has been recommended as an accurate adjunct to physical examination. The aim of this study was to evaluate the accuracy of HHD imaging in comparison with duplex ultrasonography.
Eighty-nine legs in 61 patients with primary varicose veins were examined with an HHD probe to detect reflux at the saphenofemoral junction (SFJ), the saphenopopliteal junction (SPJ) and in thigh perforators (TPs). Patients then underwent duplex imaging and the results of the tests were compared.
The sensitivity of the HHD technique was 73 per cent at the SFJ, 77 per cent at the SPJ and 51 per cent for TPs. In primary varicose veins the surgery planned using HHD imaging alone would have left residual sites of reflux in 24 per cent.
Examination with HHD ultrasonography is not sufficiently accurate to plan varicose vein surgery. Duplex imaging is recommended before all operations for primary varicose veins.
体格检查在检测静脉曲张反流源方面并不可靠。手持多普勒（HHD）超声检查已被推荐为体格检查的准确辅助手段。本研究的目的是评估HHD成像与双功超声检查相比的准确性。
使用HHD探头对61例原发性静脉曲张患者的89条腿进行检查，以检测大隐静脉股静脉交界处（SFJ）、大隐静脉腘静脉交界处（SPJ）和大腿穿通支（TPs）的反流情况。然后对患者进行双功成像，并比较检查结果。
HHD技术在SFJ处的敏感性为73%，在SPJ处为77%，在TPs处为51%。在原发性静脉曲张中，仅使用HHD成像计划的手术会使24%的患者留下残余反流部位。
HHD超声检查不够准确，无法用于规划静脉曲张手术。建议在所有原发性静脉曲张手术前进行双功成像。
