超声造影对下腔静脉滤器血栓的诊断价值

doi:10.16139/j.1007-9610.2024.05.12

摘要/Abstract

摘要：

目的：评价超声造影(CEUS)在下腔静脉滤器植入病人滤器取出前对滤器血栓的诊断价值。方法：从2023年6月至2023年11月，本院收治127例拟行下腔静脉滤器取出术的病人，其中53例行CEUS检查。观察CEUS模式下滤器内及滤器周围造影剂信号增强情况。根据造影剂信号缺损情况进行分级，并与数字减影血管造影（DSA）结果比较。结果：在CEUS模式下，下腔静脉内可见造影剂显像，并清晰显示血栓位置相关的造影剂信号缺损。根据CEUS显示的血栓大小和部位，滤器血栓分为4类：41例0类，8例Ⅰ类，3例Ⅱ类，1例Ⅲ类。CEUS与DSA在对滤器血栓分级方面差异无统计学意义（P>0.05）。根据滤器血栓的分类不同，对53例下腔静脉滤器病人采取不同的滤器取出方案。所有病人在滤器取出期间均未发生大出血事件或症状性肺栓塞等并发症。结论：CEUS有效评估下腔静脉滤器植入病人取出滤器前滤器血栓的情况，从而为术前评估手术风险、选择治疗方案以及预防并发症提供依据，具有重要的临床价值。

关键词: 下腔静脉滤器, 超声造影, 数字减影血管造影, 深静脉血栓

Abstract:

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in assessing thrombus of inferior vena cava filters before filters removal. Methods We analyzed 127 patients who scheduled for inferior vena cava filter extraction from June to November 2023, 53 of which underwent CEUS examination. The enhancement of contrast agent signal within and around the filter was observed under CEUS mode. The thrombus was classified based on the signal loss of contrast agent and then compared with digital subtraction angiography(DSA). Results In the CEUS mode, the contrast agent was visualized within the inferior vena cava, clearly revealing signal loss for the thrombus location. Based on the size and location of the thrombus, filter thrombus was categorized into four groups: 41 cases of type 0, 8 cases of type Ⅰ, 3 cases of type Ⅱ, and 1 case of type Ⅲ. No significant difference in thrombus classification was observed between CEUS and DSA (P>0.05). According to the classification of filter thrombus, different extraction schemes were applied to 53 patients with inferior vena cava filters. There were no major bleeding events or symptomatic pulmonary embolism happened. Conclusions CEUS is valuable for evaluating filter thrombus prior to removal, providing a basis for preoperative assessment of surgical risks, selection of treatment plans, and prevention of complications.

Key words: Inferior vena cava filter, Contrast-enhanced ultrasound (CEUS), Digital subtraction angiography(DSA), Deep vein thrombosis

中图分类号:

张健, 钱伟清, 衣晓蕾. 超声造影对下腔静脉滤器血栓的诊断价值[J]. 外科理论与实践, 2024, 29(05): 441-445.

ZHANG Jian, QIAN Weiqing, YI Xiaolei. Value of contrast-enhanced ultrasound in diagnosis of thrombus in inferior vena cava filter[J]. Journal of Surgery Concepts & Practice, 2024, 29(05): 441-445.

图/表 5

参考文献 17

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Classification	CEUS（n=53）	DSA（n=53）	P value
0	41（77.36）	43（81.13）	0.250
Ⅰ	8（15.09）	7（13.21）
Ⅱ	3（5.66）	2（3.77）
Ⅲ	1（1.89）	1（1.89）