摘要
目的分析腘静脉漂浮血栓(FFT)的超声声像特征,并随访FFT溶栓治疗后的再通情况,探讨超声声像特征与FFT预后的关系。方法回顾性纳入因膝关节周围骨折导致腘静脉FFT且经数字减影血管造影(DSA)或超声造影确诊的48例病人。在超声上根据弹头滑行征对FFT进行诊断,并分析该征象对FFT的诊断准确度。观察病人经抗凝治疗后1周、1个月时行超声随访的腘静脉FFT再通情况,将病人分为再通组(完全再通)和血栓组(仍存在血栓)。采用χ^(2)检验或Fisher确切概率检验对2组病人超声初次诊断FFT的回声、位置、漂浮度进行比较。结果弹头滑行征诊断FFT的准确度为100%。经抗凝治疗1周后,再通组病人为22例(45.8%),血栓组26例(54.2%)。再通组初诊影像上极低回声、漂浮度高的FFT占比均高于血栓组(均P<0.05)。抗凝治疗1个月后,再通组病人为42例(87.5%),血栓组为6例(12.5%)。再通组初诊影像上FFT尾部位置位于腘静脉远段者的占比高于血栓组(P<0.05)。结论超声可准确诊断腘静脉FFT,极低回声FFT、FFT漂浮度高、尾部位于腘静脉远段的病人预后较好。
Objective To analyze the ultrasound imaging characteristics of free-floating thrombosis(FFT)in the popliteal vein,follow up the recanalization after thrombolysis treatment,and to explore the relationship between ultrasound imaging characteristics and FFT prognosis.Methods A retrospective analysis was conducted on 48 patients with FFT in the popliteal vein caused by fractures around the knee joint,which were confirmed by digital subtraction angiography(DSA)or contrast-enhanced ultrasound.The FFT was diagnosed by the“sliding sign”on ultrasound,and the diagnostic accuracy of this sign for FFT was analyzed.Ultrasound follow-up was performed 1 week and 1 month after anticoagulant therapy to observe the recanalization of FFT in the popliteal vein,and patients were divided into the recanalization group(complete recanalization)and the thrombosis group(thrombus still existed).The chi-square test or Fisher’s exact probability test was used to compare the echo,location,and floatability of FFT in the initial diagnosis of ultrasound between two groups.Results The diagnostic accuracy of the sliding sign for FFT was 100%.After 1 week of anticoagulant therapy,twenty-two patients(45.8%)were in the recanalization group and 26 patients(54.2%)were in the thrombosis group.The proportion of FFT with extremely low echo and high floatability on the initial diagnosis images in the recanalization group was higher than that in the thrombus group(all P<0.05).After 1 month of anticoagulant therapy,there were 42 patients(87.5%)in the reperfusion group and 6 patients(12.5%)in the thrombosis group.The proportion of patients with FFT tail located in the distal segment of the popliteal vein on the initial diagnosis image in the recanalization group was higher than that in the thrombus group(P<0.05).Conclusion Ultrasound is an effective diagnostic tool for identifying FFT.FFT exhibits extremely low echo,high floatability,and tail located in the distal segment of the popliteal vein,the patients have a more favorable prognosis.
作者
孛茹婷
杜立龙
戴兵
袁宇
BO Ruting;DU Lilong;DAI Bing;YUAN Yu(Department of Ultrasound,Tianjin Hospital,Tianjin 300211,China;Department of Trauma Orthopedics,Tianjin Hospital;Department of Vascular Surgery,Tianjin Hospital)
出处
《国际医学放射学杂志》
2025年第1期48-52,共5页
International Journal of Medical Radiology
基金
天津市卫生健康行业高层次人才选拔培养工程项目(TJSQYYXR-D2-097)。
关键词
超声
骨折
漂浮血栓
深静脉血栓
Ultrasound
Fracture
Free-floating thrombus
Deep vein thrombus
