直接法CT静脉造影、彩色多普勒超声联合D-二聚体检测对下肢深静脉血栓诊断的临床意义

发布时间：2018-02-02 16:29

本文关键词： DVT 直接法MSCTV CDS　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨直接法idose重建低剂量多层螺旋CT血管造影(MSCTA)、彩色多普勒超声(CDS)、外周血D-二聚体(D-D)含量检测在下肢深静脉血栓(DVT)诊断中的意义。材料与方法:遴选本科室从2014年2月到2016年10月之间疑似DVT病人128例。明确患者的发病原因及影响D-二聚体测量结果的相关病史,记录每位患者MSCTV、CDS及外周血D-二聚体的检查结果,比较外周血D-二聚体含量在血栓所处异同部位及病程长短的改变情况和两种影像检查技术的优劣势。结果:在不同分型的DVT中,D-二聚体的浓度有差异,中央型、周围型外周血D-D浓度为4.45±1.2、2.48±0.24mg/L,显著较正常值高,周围型D-聚体浓度0.41±0.12mg/L几乎接近一般值范围;直接法MSCTV、CDS影像学检查技术和血浆D-二聚体检测确诊DVT的敏感性依次是99.2%、98.4%、100%,特异度依次为75%、80%、60%,阳性率、阴性率依次为99.2%、99.2%、98.4%,88.3%、66.7%、100%,准确度依次为98.4%、97.6%、98.4%;MSCTV、CDS确诊中央型DVT的敏感度分别为96.9%、93.8%,周围型DVT分别是92.6%、66.7%,混合型DVT分别是93.8%、84.4%。结论:由于血浆D-D极高的敏感性,能作为可疑DVT的排除性标准;直接法MSCTV、CDS判定DVT的符合度大致相似;CDS对周围型DVT(远心端)栓子的敏感性低,而直接法MSCTV可以填补此缺陷。
[Abstract]:Objective: to investigate the direct idose reconstruction of low dose multislice spiral CT angiography (MSCTA). Detection of D-D in Peripheral Blood in DVT patients with Deep Venous Thrombosis. Significance in diagnosis-Materials and methods:. From February 2014 to October 2016, 128 suspected DVT patients were selected. The results of MSCTVU CDS and D- dimer in peripheral blood of each patient were recorded. To compare the changes of peripheral blood D-dimer content in the location and duration of thrombus and the advantages and disadvantages of the two imaging techniques. Results: in different types of DVT. The D-D concentration of peripheral blood of central type and peripheral type was 4.45 卤1.2 卤2.48 卤0.24 mg / L, which was significantly higher than that of normal. The concentration of peripheral D- polymer was 0.41 卤0.12 mg / L, which was close to the general range. The sensitivity of direct MSCTV CDS imaging and plasma D-dimer in the diagnosis of DVT was 99.2 and 98.4%, and the specificity was 75%. The positive rate and the negative rate were 99.2 and 99.2, 98.4 and 88.36.70.The accuracy was 98.4%. 97.6 and 98.4; The sensitivity of MSCT CDS in the diagnosis of central DVT was 96. 9% and 93. 8%, respectively, and the peripheral DVT was 92. 6% and 66. 7% respectively. Conclusion: plasma D-D is highly sensitive and can be used as an exclusion standard for suspicious DVT. The coincident degree of DVT determined by direct MSCTV CDS was similar. The sensitivity of CDS to peripheral DVT (distal end) embolus is low, and direct MSCTV can fill this defect.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.6;R816.2;R445.1

【相似文献】