Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied. The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured, furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%, 66.7%, 97.0%, 100%, and 97.1%, and 98.4%, 83.3%, 98.4%, 83.3%, and 97.1%, respectively. The plasma D-dimer in acute phase 〔(6 451±4 012.22) μg/L〕 and subacute phase 〔(2 063±1831.35) μg/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310±66.70) μg/L〕, Plt;0.01 and Plt;0.05, which was not different from that in chronic phase 〔(466±350.52) μg/L〕. Meanwhile, the plasma D-dimer in mixed limb venous thrombosis group 〔(4 464±3 753.16) μg/L〕 and central limb venous thrombosis group 〔(2 149±1 911.53) μg/L〕 were significantly higher than that in control group (Plt;0.05 and Plt;0.01), which was not different from that in peripheral limb venous thrombosis group 〔(560±315.62) μg/L〕. Conclusion Color Doppler ultrasonography is an optimal method and the plasma D-dimer is a predictive index in diagnosis of lower limb DVT.
ObjectiveTo evaluate the value of high-frequency color Doppler ultrasonography in the diagnosis of femoral hernia. MethodsThe ultrasonographic features of 39 femoral hernias in 37 patients treated between March 2008 and October 2013 were retrospectively analyzed, and the results were confirmed by surgery. ResultsThirty-nine femoral hernias were diagnosed by surgery, including 19 in the right side, 16 in the left side, and 2 with double-side hernias. Thirty-seven femoral hernias were diagnosed with ultrasonography. Two femoral hernias were misdiagnosed as lipoma in one, and as enlarged lymph nodes in one, respectively. Ultrasound diagnosis accurate rate was 94.9% (37/39). Hernia content could be seen through surgery in 28 cases, and the ultrasound accurate rate in assessing the hernia content was 85.7% (24/28). ConclusionUltrasonography is the first choice for improving the diagnosis efficacy of femoral hernia.
Objective To investigate the value of color Doppler ultrasonography in the examination of perforating veins of the lower extremities by comparing with X-ray antegrade venography. Methods Fifty-three patients (60 lower extremities) clinically diagnosed with varicosis of the great saphenous vein from January 2014 to March 2016 were selected for color Doppler ultrasonography and X-ray antegrade venography. The results were compared and confirmed by surgery. Results Forty-seven lower extremities were diagnosed with perforating venous valve insufficiency by color Doppler ultrasonography, while 50 lower extremities by X-ray antegrade venography. There was no significant difference between the two methods (χ2=0.800, P=0.371). A total of 78 perforating veins were detected by color Doppler ultrasonography, with 1–4 perforating veins per one lower extremity. Among them, 66 perforating veins had an internal diameter of 2–5 mm, accounting for 84.6%. Except two perforating veins with an internal diameter <2 mm, the rest showed reflux. In addition, a total of 73 perforating veins presented distance to the pelma of 10–32 mm (foot-boot), accounting for 93.6%. Fifty-two lower extremities with varicosis of the great saphenous vein underwent laser ablation of the great saphenous vein with high ligation or + devascularization of perforating veins. Compared with operation findings, color Doppler ultrasonography in diagnosis of perforating venous valve insufficiency had 37 true positives, 2 false positives, 10 true negatives and 3 false negatives, and the sensitivity was 92.5% (37/40), the specificity was 83.3% (10/12), the accuracy rate was 90.4% (47/52). Conclusions Color Doppler ultrasonography can accurately localize perforating veins, measure the internal diameter and observe the degree of reflux. It is of high sensitivity and accuracy in the diagnosis of perforating venous valve insufficiency. Moreover, it is safe, simple and economical, and suitable for preoperative and intraoperative diagnosis and localization.