Relationship between color Doppler ultrasound features of the insufficient perforating veins and clinical stages of chronic venous insufficiency
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Objective: To evaluate the relationship between the ultrasonic features of perforating veins(PVs) and the clinical stages in patients with venous insufficiency of lower extremities. Methods: In 45 cases(50 lower limbs) with differernt clinical stages of venous incompetence of lower extremities, the number, diameter and blood flow velocity of PVs were examined by color Doppler ultrasound. Results: There were positive relationships between PVs' number, diameter or blood flow velocity and the clinical stages, with a relationship index of 0.48, 0.55 and 0.51, respectively(P0.05). Conclusion: Higher clinical stages were accompanied with greater number, wider diameter or faster blood flow of PVs.Keywords:
Chronic Venous Insufficiency
Color doppler
Doppler ultrasound
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Objective To observe reliability of color Doppler ultrasound in diagnosis lower extremity deep venous thrombosis(DVT).Methods 45 lower limbs in 41 cases suspected as deep venous thrombosis were examined by CDFI.The results were analyzed.Results In this group,26 cases of 41 were found venous thrombosis, 11 cases in the right and 4 cases in both.The most common site of venous thrombosis was the left lower limbs.The femoral vein,superficial femoral vein ,deep femoral vein, popliteal vein were involved frequently.Hyper-echo or hypo-echo masses were seen in the lumen.Thin blood flow or no blood flow was observed in color Doppler.Slow velocity was detected or the velocity was not changed with deep breath in pulse Doppler.Conclusion Color Doppler ultrasound has high reliability in diagnosing lower extremity DVT.It an excellent diagnostic tool in clinical treatment of such disease.
Key words:
Ultrasonography ,Doppler,color; Venous thrombosis
Popliteal vein
Femoral vein
Color doppler
Lumen (anatomy)
Doppler ultrasound
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Objective:To investigate the clinical value of color Doppler flow imaging(CDFI) in diagonosis of perforating venous insufficiency of the lower extremity.Methods:The clinical data of 64 cases(82 limbs) undergoing high ligation and striping of great saphenous vein and perforator surgery were reviewed retrospectively.The dilated and insufficient perforating venous were diagnosed and located by CDFI.The results were compared with surgery.Results:Total consistent rate,sensitivity,specificity,omission diagonostic rate,mistake diagnositic rate,Youden index,Odd product,positive predictive value,negative predictive value,and Kappa of CDFI in diagnosis of perforating venous insufficiency of the lower extremity was respectively 95.8%、96.5%、88.2%、3.5%、11.8%、0.837、206.5、98.8%、71.4% and 0.766(P0.0001).The CDFI foundings were consistent with operation results very well.Conclusion:CDFI is a useful technique for the diagnosis and locating the dilated and insufficient perforating venous correctly and provide important basis for the operation.
Great saphenous vein
Color doppler
Youden's J statistic
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AIM: To observe the changes of the lower-limb venous system of women before and after delivery,to explore the causes and incidence of the lower-limb venous thrombosis during gestation and puerperium, and to discuss the diagnostic value of two-dimensional(2-D) ultrasound and color Doppler flow image (CDFI). METHODS: Ninety-six pregnant and postpartum women were recruited for the study. Femoral veins, great saphenous veins and small saphenous veins were assessed in both lower limbs using 2-D ultrasound and CDFI. The diameters were measured. The spontaneous blood flow echogenicity, venous thrombosis and reflux were observed in each vein. RESULTS: All veins dilated with increasing gestation. The diameters of the great saphenous veins increased significantly (P0.05). Spontaneous blood flow echogenicity in the femoral veins was clearly visible and marked in 39.1% of cases during the second trimester of pregnancy and 92.5% during the third trimester. The vein thrombosis was formed most easily within 3 months after delivery. CONCLUSION: The increase in lower-limb venous pressure during pregnancy leads to venous distention and worsens blood stasis. The examination by ultrasound diagnosis can demonstrate the situation of lower-limb veins safely and quickly, and can give more valuable information for clinical prevention and treatment.
Echogenicity
Venous stasis
Color doppler
Femoral vein
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Objective To estimate the role of color Doppler flow imaging(CDFI) in diagnosis of perforating venous insufficiency in the lower extremity.Methods Fifty-four cases with chronic venous insufficiency were reviewed and analyzed.The diagnostic results of insufficient perforating veins location by CDFI were compared with the results from vein venography and surgery.Results In the 54 cases,156 perforating veins were found with reflux by CDFI,145 perforating veins were ligated during subfascial endoscopic perforator surgery(SEPS).Only 130 out of 156 perforating veins location were confirmed by SEPS.The match rate by CDFI for diagnosis of insufficiency perforating veins was 89.7%.However,only 122 perforating veins were found in the same group patients by vein venography,and the match rate by venography for diagnosis of insufficiency perforating veins was 84.1%.There was no statistical significant difference for diagnosis of insufficiency perforating veins between CDFI and vein venography,(P0.05).Conclusion CDFI is a useful technique for the diagnosis of insufficiency perforating vein in lower extremity.It can provide an unharmful,reliable inspection for clinical diagnosis.
Venography
Chronic Venous Insufficiency
Color doppler
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Objective To determine time threshold value of venous reflux in lower extremity veins with color Doppler ultrasonography.Methods Forty patients who would perform venous valve reconstruction in the first valve of superficial femoral vein and 20 normal lower extremities were detected with color Doppler ultrasonography, their venous reverse time was measured in the first valve of superficial femoral vein, results of measuring and surgical detection were compared. Results Color Doppler ultrasonography had high accuracy (95%) for the evaluation of venous reflux when time threshold value of venous reflux was defined as reverse flow for greater than 0.5 second. Conclusions Color Doppler ultrasonography can accurately identify limbs with and without venous reflux when venous reflux is defined as reverse flow greater than 0.5 second.
Femoral vein
Color doppler
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Objective To assess the clinical significance of preoperative localization of incompetent perforator veins by color Doppler ultrasonography in venous ulcer of lower extremities.Methods Of the 63 lower limbs from 59 patients with venous ulcer of lower extremities,41 limbs underwent color Doppler ultrasonography and 22 limbs underwent venous anterograde visualization,respectively,so as to compare the positive rates of incompetent perforator veins.Results There was no significant difference in the positive rates incompetent perforator veins between the two methods of detection(97.5% vs.90.9%,P0.05).Conclusion Color Doppler ultrasonography is preferable to other methods for its noninvasiveness,precise localization of incompetent perforator veins and therefore,it should be regarded as the top clinical option in the examination of venous ulcer of lower extremities.
Color doppler
Superficial vein
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Abstract Ninety‐eight legs in 73 patients were evaluated with image‐directed Doppler ultrasound for suspected chronic venous insufficiency. Examinations of the entire venous system were performed to determine lumen patency and valvular competence. Reflux during Valsalva maneuver in the femoral and great saphenous vein, and, after release of distal compression in the popliteal vein, indicated valvular incompetence. Twenty limbs had normal veins; Baker's cysts were found in three. Superficial venous insufficiency was found in 25 cases. Deep reflux, either alone or in combination with superficial reflux, was the predominant pathological feature (53 legs). Photoplethys‐mographic studies of the veins were performed on 24 limbs. Image‐directed Doppler ultrasound was more successful in defining the exact site of venous incompetence and in detecting nonvenous pathology. By the combination of real‐time imaging of the vein with gated Doppler sonography of flow, image‐directed Doppler sonography is becoming the method of choice for the investigation of chronic venous insufficiency. © 1994 John Wiley & Sons, Inc.
Doppler ultrasound
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Obiective To evaluate the value of color doppler ultrasound(CDU) in diagnosis of venous diseases in the lower extremity. Methods 141 cases with clinical lower limb venous diseases were examined by CDU. Results 124 positive cases were found in 141 cases, 61 patients with deep venous thrombosis, 49 patients with venous valve insufficiency, 14 patients with others venous diseases. Conclusions CDU is a noninvasivem, realtime and sensitive method to detect venous diseases in the lower extremity.
Color doppler
Chronic Venous Insufficiency
Doppler ultrasound
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Objective To evaluate the value of color Doppler ultrasound in the diagnosis of deep venous thrombosis of the lower limbs.Methods A total of 212 cases clinically suspected as deep venous thrombosis of the lower extremity were examined with color Doppler ultrasound.The anatomic tracing,diameter,wall,intraluminal echogenicity and thrombosis echogenicity of the deep veins of the lower extremity were observed.Results Totally,201 deep veins were diagnosed as thrombosis by color Doppler ultrasound.The features of thrombosis on ultrasound were enlarged diameter of vessels,intraluminal dim,hypoechogenic or heterogeneous weak echogenicity,undistinguishable vascular structure,and incompressible vein under slight compression with probe.Color Doppler ultrasound revealed the absence of blood flow or slender blood flow signal in veins.Conclusion Color Doppler ultrasound is valuable in the diagnosis of deep venous thrombosis of the lower limbs.It is an accurate,safe,non-invasive and convenient method in early diagnosis,treatment and reducement of the complications clinically.
Echogenicity
Color doppler
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Objective To compare the detection rate and diagnostic accuracy of the incompetent perforating veins between color Doppler ultrasonography and phlebography in patients with venous ulcers of lower limbs.Methods During the period from Sep.2008 to Aug.2011,a total of 35 cases with venous ulcers in lower limbs were admitted to authors' hospital.Both Doppler ultrasonography and phlebography were performed in all the patients.The detection rate and diagnostic accuracy of the incompetent perforating veins were recorded and the results were compared between the two methods.Results Of 35 cases with venous ulcers(44 diseased lower limbs),a total of 238 perforating veins were demonstrated by phlebography(n = 233) or by Doppler ultrasonography(n = 236),with P = 1.0.Phlebography detected 100 incompetent perforating veins(42.0%),while Doppler ultrasonography revealed 34(14.4%) or 111(48.0%) incompetent perforating veins when reflux time of 0.5 second or 0.35 second was taken as the standard critical point respectively.Most perforating veins and incompetent perforating veins were located at the lower part of the leg.Taking phlebography findings as reference,the specificity of 0.5 second and 0.35 second reflux time was 100% and 83.2% respectively,and the sensitivity of 0.5 second and 0.35 second reflux time was 34% and 89% respectively,and the Kappa value was 0.37 and 0.71 respectively.When combination use of 0.35 second reflux time and 3 mm diameter was employed as standard critical point,the specificity,sensitivity and Kappa value were 95.4%,82% and 0.79,respectively.Conclusion For the evaluation of the incompetence of perforating veins in patients with venous ulcers of lower limbs,Doppler ultrasonography carries higher detection rate of incompetent perforating veins,and is in accord with phlebography findings.The diagnostic accuracy of incompetent perforating veins will be further improved if combination use of 0.35 second reflux time and 3 mm diameter is employed as standard critical point.
Color doppler
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