Ultrasonic Diagnosis And Analysis Of Calf Muscular Venous Thrombosis

Objective 1 Summarize the ultrasonography features of calf muscular venous thrombosis examined by color Doppler ultrasound.Investigate the clinical value of color Doppler ultrasound diagnosis of isolated calf muscular venous thrombosis.2 Investigate the method of haw to improve the color Doppler ultrasound diagnosis s'accuracy of isolated calf muscular venous thrombosis and its main differential diagnosis.Method From May 2007 to March 2010, in General IHospital of Tianjin Medical University, used PHILIPS HD-11 color Doppler ultrasonic which the probe's frequency is 3-12MHz examined and diagnosised 45 isolated calf muscular venous thrombosis cases of hospitalization and outpatient, rule out those patients who combined with deep vein thrombosis. All cases were detailed records of their clinical symptoms, detected by immunoturbidimetric D-dimer (DD) and record the inspection results, record other imaging findings and the exact location of Thrombosis or their branch vein. First use of supine position, inspection in accordance with the order:the total vein, great saphenous vein, superficial femoral vein and deep femoral vein.Then sitting, Legs bent, double-check the calf muscle veins. The probe placed on the anterolateral aspect of upper leg, track two anterior tibial vein marked by the anterior tibial artery. Check the popliteal vein and the small saphenous vein with prone position and lateral position. Find the posterior tibial vein at dorsal medial tibia. Search for the Peroneal at vein medial fibula (Posterior tibial vein is the extension of the popliteal vein, which import posterior tibial vein or directly into the popliteal vein is the the peroneal vein, the soleus muscle venous plexus is in the soleus muscle).Check vein Patency, understand the depth of venous and reflux through the Valsalva test.Analyze and summarize the characteristics of two-dimensional and color Doppler imaging; the operation essentials of Color Doppler examination; compared with the disease which is easily confused; Summarize their similarities and differences.Result 45 cases were all involved Unilateral leg, soleus muscle venous plexus thrombosis were 20 cases, gastrocnemius venous plexus thrombosis were 13 cases, posterior tibial venous plexus thrombosis were 9 cases, peroneal vein thrombosis were 3 cases. Five cases were confirmed by angiography, the other cases's thrombus volume decreased after thrombolytic therapy or symptoms reduced. All cases D-dimer testing to Yin. Color Doppler sonographic features are:involved vein's wall is not smooth, diameter is irregularly widened,there are weak echo clumps endovenous. When cross-section,Section into a round or oval. The lumen has no change after probe pressure. If the vein was completely occluded, the color flow signal within the lumen were disappearanced. After 6 weeks clinical treatment,reviewed with ultrasound, Showed smooth vessel wall,the thrombus echo reflection increased. There were 44 cases's D-dimer were positive in 45 cases.Conclusion Color Doppler ultrasound can show the blood vessels and soft tissue structures clearly, No damage, real-timeand repetitive inspection are the advantages of color Doppler ultrasound. Although the location of isolated calf venous plexus thrombosis is deep, however, if the ultrasound physicians were familiar with the anatomical structure, combined Clinical symptoms and D-dimer test results,they are able to diagnose the disease accurately.Therefore, color Doppler ultrasound examination has important diagnostic value. Some patients whose symptoms are hiddenly are overlooked easily. Examine small leg venous plexus with color Doppler ultrasound should be a part of routine examination in order to avoid misdiagnosis happening.