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中华医学超声杂志(电子版) ›› 2018, Vol. 15 ›› Issue (04) : 258 -262. doi: 10.3877/cma.j.issn.1672-6448.2018.04.005

所属专题: 文献

腹部超声影像学

肾静脉栓塞的彩色多普勒超声征象及其诊断价值
金金1, 王亚红1, 王红燕1, 徐钟慧1, 韦瑶1, 王莹1, 葛志通1, 张怡璇1, 李建初1,()   
  1. 1. 100730 中国医学科学院 北京协和医学院 北京协和医院超声诊断科
  • 收稿日期:2018-01-09 出版日期:2018-04-01
  • 通信作者: 李建初
  • 基金资助:
    中国医学科学院医学与健康科技创新工程:重大协同创新项目-重大前沿研究(2016-I2M-1-011); 国家自然科学基金(6157011093); 北京市自然科学基金(7162159)

Color Doppler ultrasonography of renal vein embolism and its diagnostic value

Jin Jin1, Yahong Wang1, Hongyan Wang1, Zhonghui Xu1, Yao Wei1, Ying Wang1, Zhitong Ge1, Yixuan Zhang1, Jianchu Li1,()   

  1. 1. Department of Ultrasonography, Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2018-01-09 Published:2018-04-01
  • Corresponding author: Jianchu Li
  • About author:
    Corresponding author: Li Jianchu, Email:
引用本文:

金金, 王亚红, 王红燕, 徐钟慧, 韦瑶, 王莹, 葛志通, 张怡璇, 李建初. 肾静脉栓塞的彩色多普勒超声征象及其诊断价值[J]. 中华医学超声杂志(电子版), 2018, 15(04): 258-262.

Jin Jin, Yahong Wang, Hongyan Wang, Zhonghui Xu, Yao Wei, Ying Wang, Zhitong Ge, Yixuan Zhang, Jianchu Li. Color Doppler ultrasonography of renal vein embolism and its diagnostic value[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(04): 258-262.

目的

通过与增强CT对比分析,探讨彩色多普勒超声在肾静脉栓塞疾病中的诊断价值。

方法

选取2014年1月至2017年9月在北京协和医院就诊的经手术病理或随访证实的40例45侧肾静脉栓塞患者,其中,15例20侧肾静脉血栓及25例25侧肾静脉癌栓,均行彩色多普勒超声及增强CT检查,总结肾静脉栓塞的超声表现,包括栓塞病灶的位置、受累静脉管腔及管壁特点、侧支形成情况及彩色多普勒表现。超声与增强CT诊断肾静脉血栓及癌栓的准确率比较采用χ2检验。

结果

彩色多普勒超声对肾静脉血栓及癌栓的诊断准确性分别为85%、84%,CT增强扫描的诊断准确性依次分别为100%、96%,差异均无统计学意义(P均>0.05)。肾静脉栓塞的主要超声征象有:(1)肾静脉管腔扩张伴实性成分填充;(2)主干内血流中断或充盈缺损;(3)肾内无明显静脉血流信号或血流信号分布稀疏。

结论

彩色多普勒超声与增强CT在诊断肾静脉栓塞上有较好的一致性,超声可作为评估肾静脉栓塞的重要影像学方式,结合病史能为肾静脉栓塞提供较为可靠的诊断依据。

Objective

Explore the diagnostic value of color Doppler ultrasonography in renal vein embolism compared with contrast-enhanced CT. Analyze and summarize the sonographic features and reasons of misdiagnosis of renal vein embolism.

Methods

Reports of color Doppler ultrasonography and contrast-enhanced CT in 15 patients with 20 renal vein thrombosis and 25 patients with 25 renal vein tumor thrombosis were retrospectively analyzed. We summarized the sonographic features including the location of emboli, the lumen and wall of the involved veins, the information of collateral circulation and the color Doppler sonographic features.

Results

The diagnostic accuracy of renal vein thrombosis and tumor thrombosis were 85% and 84% for ultrasound, 100% and 96% for contrast-enhanced CT, the difference was not statistically significant (all P>0.05). The typical sonographic features include (1) Expansion of the renal vein and full of solid echogenicity; (2) No flow signals or flow filling defect in renal veins; (3) No or sparse venous flow signal in the involved kidney.

Conclusions

Color Doppler ultrasonography and contrast-enhanced CT have a good consistency in the diagnosis of renal vein embolism. Color Doppler ultrasonography can be used as an important imaging method to evaluate the renal vein embolism, which can combine medical history and provide a more reliable basis for the diagnosis of renal vein embolism.

图5,6 患者,女性,39岁,肾病综合征,右肾静脉与下腔静脉交界处管腔内陈旧性血栓形成超声图像。图5为右肾静脉与下腔静脉交界处管腔内可见不均质高回声部分阻塞管腔,与管壁分界清晰(箭头所示);图6为该处管腔内血流充盈不完全
表1 超声、增强CT诊断肾静脉栓子良恶性结果
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