The Diagnostic Value Of The Ultrasonography In The Upper Extremity Venous Thrombosis

Objective:Evaluate the diagnostic value of the Colored Doppler Flow Image (CDFI) in upper extremity venous thrombosis via observing and analyzing the ultrasound image characteristics of upper extremity venous thrombosis in patients of different periods.Materials and methods:Give the66patients CDFI examination who was clinically suspected suffered from upper extremity venous thrombosis that hospitalized in Tengzhou Central People’s Hospital during October2007to July2014. Observe the upper extremity vein for its diameter, tube wall shape, tube cavity echo characteristics, thrombosis range, intravascular blood filling situation, spectrum morphology and blood flow parameters, analyze the ultrasound image of the upper extremity venous thrombosis and the changes of blood flow parameters in different periods, so as to provide more valuable diagnostic basis for clinical experience. Among the66cases, venous catheterization were42cases that account for63.7%, arteriovenous fistula5cases account for7.6%, after surgery cancer patients11cases account for16.7%, humerus fracture3cases account for4.5%, thoracic outlet syndrome1case account for1.5%, upper extremity injury1case account for1.5%, intravenous infusion1case account for1.5%and no clear etiology2cases account for3.0%.Results:There are58cases that were diagnosed upper extremity venous thrombosis by ultrasonography examination in66cases of clinically suspected patients, in which the male27cases account for46.6%and the female31cases account for53.4%. Age range was from42year-old to73year-old with an average age of55year-old. In58patients be diagnosed as upper extremity venous thrombosis, the diameter of the affected blood vessel in acute stage of thrombosis be widened significantly compared with the opposite side and the difference showed statistically significance(P<0.01). The intraluminal thrombus can be no echo or low echo. In the completely blocked lumen segment there is no blood flow signal. In incompletely blocked lumen segment there is filling defect and the period-phase character of the blood spectrum morphology weakened or disappeared. In subacute stage, the inner diameter of the embolic blood vessel is slightly reduced compared with acute stage, but they showed no statistically significance(P>0.05). The difference of the thrombus in this stage is distinct so we can not specify the thrombus period according to the thrombus echo. The blood vessel can be partly restored and the flat blood spectrum morphology can be detected at the repatency segment. In chronic stage, the inner diameter of the embolic blood vessel is significantly reduced compared with acute stage(P<0.01). The blood vessel restored in different degree and the affected degree to the breath of the blood spectrum morphology diverse according to different restore condition.Conclusion:Different ultrasonographic performance of upper extremity venous thrombosis was detected at different phrases. Ultrasonography examination has significant value for distinguishing different phrases of upper extremity venous thrombosis and observing the region, extent, blood flow around the thrombosis, especially for the post-PICC-surgery patients with upper extremity venous thrombosis, and has important clinical value in assessment of thrombolytic efficacy and selection of treatment.