Study Of Correlation Between Varicose Veins Of Lower Limb And Ultrasound-Measured Blood Volume Of Inferior Vena Cava

Objective: To explore the correlation between different CEAP clinical grades of lower limb varices and blood volume of inferior vena cava by color Doppler ultrasound(CDUS).Methods: From December 1 2018 to December 1 2019,we randomly selected 109 patients with varicose veins of the lower limbs from department of vascular surgery in our hospital.As the case group,th-ey were examined by CDUS in order to have a correct diagnosis and treatment.According to the clinical classification of Clinical-Eti-ology-Anatomy-Pathophysiology(CEAP)and venous skin lesions in c-hronic venous diseases,we divided the cases into group A(classes C1 to C3)with 57 patients a-nd group B(classes C4 to C6)with 52 ones.The control group(group C)with 27 healthy subjects were matched with the cases in gender and age.Choosing the cross-section of the lower section of the inferior vena cava(IVC)and the same level of the abdominal aorta(AA)to measure the long and short diameters of IVC,the diameters of AA,their circumference and calculate their area in the mode of Conventional two-dimensional Ultrasound combined with vascular enhancement technology(VET),and measure the maximum flow rate of IVC and the average flow rate of AA in the mode of Doppler ultrasound by the convex array probe(1 to 5 MHz).At last we need to calculate their blood flow.Aortic valve annulus diameter,aortic velocity time integral,heart rate were measured in the mode of conventional two-dimensional Ultrasound and Doppler Ultrasound by Phased array probes (1 to 5 MHz),then calculate their Stroke Volume and Cardiac Output.The differences and correlations of all study parameters were analyzed among the three groups.Results: 1.There were no significant differences in gender,age,and height among the three groups(all P>0.05);however,the proportion of lower limb varicose veins in men was higher than that in women.The body weight,body surfacearea,and body mass index of group B were significantly different from those of group A and group C(all P<0.05),and there were no significant differences between group A and group C(all P>0.05).The different CEAP clinical grades of varices had no significant correlation with gender,age,and height(all P>0.05),but they were positively correlated with body weight,body surface area,and body mass index(all P<0.01).2.The length and circumference of the inferior vena cava of group A and group B were significantly larger than those of group C,and the differences were statistically significant(both P<0.05);but the differences between group A and group B were not statistically significant(both P>0.05).The blood flow of inferior vena cava of group B was higher than that of group C,and the difference was statistically significant(P<0.05).There was no significant difference between group A and group B,or group A and group C(all P>0.05).There were no significant differences in the short diameter,maximum blood flow velocity,and cross-sectional area of the inferior vena cava among the three groups(all P>0.05).3.The diameter,circumference,cross-sectional area,and blood flow of abdominal aorta in group B were higher than those in group C,and the differences were statistically significant(all P<0.05);there was no significant difference between group A and group B,or group A and group C.(both P> 0.05).There was no significant difference in the average blood flow velocity of t-he abdominal aorta among the three groups(all P>0.05).4.The diameter of the aortic annulus in group B was larger than that in group C,and the difference was statistically significant(P<0.05);but there was no significant difference between group A and group B,or group A and C(all P>0.05).The aortic velocity time integration of group B was longer than that of group A,and the difference was statistically significant(P<0.05);but the differences between group B and group C,or group A and group C were not statistically significant(all P>0.05).The stroke volume and output of cardiac of group B were larger than those of group A and group C,and the differences were statistically significant(both P<0.05);but the differences between group A and group C were not statistically significant(P>0.05).There was no significant difference in heart rate among the three groups(all P> 0.05).5.The different CEAP clinical grades of varices were positively correlated with the long diameter,perimeter,blood flow of inferior vena cava,inner diameter,perimeter,cross-sectional area,blood flow of abdominal aorta,inner diameter of aortic annulus,aortic velocity time integral,and the stroke volume,output of cardiac(all P<0.05),and there was no significant correlation with the short diameter,maximum blood flow velocity,area of inferior vena cava,mean velocity of abdominal aorta or heart rate(all P>0.05).6.Positive correlation were found in Inferior vena cava blood flow,abdominal aorta blood flow,stroke volume,cardiac output(all P<0.05).Conclusion: The greater the weight,body surface area,and body mass index of patients with varicose veins in the lower limbs,the higher the clinical grades of CEAP and the more serious the skin lesions.The increasing of length and circumference of the inferior vena cava in the cross-section are sensitive indicators for predicting the development of varicose veins in the lower limbs.The important indicators of the severity of varicose veins of the lower limbs are the increasing of Inferior vena cava blood flow,inner diameter,perimeter,cross-sectional area,blood flow of abdominal aorta,inner diameter of the aortic annulus,stroke volume and output of cardiac.Therefore,Color Doppler Ultrasound can evaluate the development of varicose veins in the lower limbs by measuring various indicators of the body's capacity status and responsiveness,such as inferior vena cava,abdominal aorta and heart,and provide patients reliable basis for early diagnosis and treatment.