Diagnostik der tiefen Beinvenenthrombose durch Real-time-Sonographie
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Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional StudyKeywords:
Popliteal vein
Femoral vein
Lumen (anatomy)
Superficial vein
Rationale: Primary leiomyosarcoma (LMS) of the vein is a rare tumor that arises from the smooth muscle cells of the vessel wall and has an extremely poor prognosis. This tumor can occur in vessels such as the inferior vena cava, great saphenous vein, femoral vein, iliac vein, popliteal vein, and renal vein; the inferior vena cava is the most common site. LMS of the femoral vein can result in edema and pain in the lower extremity; therefore, it is not easy to be differentiated from deep vein thrombosis (DVT). Moreover, virtually no studies have described the ultrasonographic features of LMS of the vein in detail. Patient concerns: We present a case of a 55-year-old woman with LMS of the left femoral vein that was misdiagnosed as having deep vein thrombosis (DVT) on initial ultrasonographic examination. The patient began to experience edema and pain in her left leg seven months previously. She was diagnosed as having DVT on initial ultrasonographic examination, but the DVT treatment that she had received for 7 months failed to improve the status of her left lower limb. Diagnoses: She subsequently underwent re-examination by means of a multimodal ultrasonographic imaging approach (regular B-mode imaging, color Doppler imaging, pulsed-wave Doppler imaging, contrast-enhanced ultrasonography), which confirmed a diagnosis of LMS. Interventions: This patient was treated successfully with surgery. Outcomes: This case demonstrates that use of multiple ultrasonographic imaging techniques can be helpful to diagnose LMS accurately. Detection of vasculature in a dilated vein filled with a heterogeneous hypoechoic substance on ultrasonography is a sign of a tumor. Lessons: The pitfall of misdiagnosing this tumor as DVT is a useful reminder.
Femoral vein
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Popliteal vein
Superficial vein
Femoral vein
Great saphenous vein
Chronic Venous Insufficiency
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Objective To explore the significance of color Doppler ultrasound in diagnosis of deep venous thrombosis.Methods Ninety patients with deep vein thrombosis were examined by color Doppler ultrasound using GE LOGIQ E9 color Doppler ultrasonographic instrument for checking bilateral iliac vein,external iliac vein,femoral vein,popliteal vein,posterior tibial vein,anterior tibial vein and its branches,in order to observe the distribution of deep vein thrombosis and various thrombotic ultrasonographic characteristics.Results 1.Deep venous thrombosis had been found in 103 limbs of 90 patients including unilateral venous thrombosis in 77 cases,bilateral thrombosis in 13 cases,venous thrombosis located in left side of 74(71.84%) limbs,and in right side of 29(28.16%) limbs.Femoral vein thrombosis occupied highest proportion,and it reached 32.04%,followed by iliac vein and femoral vein reached 21.36%,the lowest percentage in iliac vein reached 4.85%.2.The ultrasound image of acute thrombosis manifested as uniform hypoechoic venous lumen occlusion or partial blockage of lumen with widened smooth wall.The ultrasound image in chronic thrombus manifested as irregular hyperechoic shape in occluded or partial occluded venous lumen,and the lumen became smaller with localized or diffuse thickening and rough inner wall.Conclusion Color Doppler ultrasound has high significance in diagnosis of deep venous thrombosis.
Lumen (anatomy)
Femoral vein
Popliteal vein
Color doppler
External iliac vein
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Background:
Two different diagnostic strategies are used to perform compression (real-time) ultrasound for the diagnosis of clinically suspected deep-vein thrombosis. One is to examine the entire proximal venous system from common femoral to distal popliteal vein; the other is a limited examination of only the common femoral and the entire popliteal vein. The latter strategy, which is less time-consuming and requires less expensive equipment, is based on a strong impression from prospective studies using limited compression ultrasound that proximal vein thrombi always involve the common femoral or popliteal vein. This impression, which is supported by the demonstrated safety at long-term follow-up of not treating patients whose limited compression ultrasound is normal at presentation and then repeated within the next week, has not been tested in a formal study. Therefore, we reviewed a large series of venograms performed in consecutive patients with clinically suspected venous thrombosis to determine the distribution of venous thrombosis in symptomatic patients.Methods:
Venograms were performed using 150 mL of radiographic contrast material. Before the study, a panel of experts agreed on the standardized criteria for the assessment of venograms. Venograms were adjudicated blindly for the presence of deep vein thrombosis and to determine the distribution of proximal vein thrombosis and isolated calf-vein thrombosis, the size of proximal thrombi, and whether they were occlusive or nonocclusive. Subsequently, the duration of symptoms was related to the venographic findings.Results:
Five hundred sixty-two venograms from consecutive patients with a first episode of clinically suspected deep vein thrombosis were adjudicated. Of these, 20 (3.6%) were inadequate for interpretation. In the remaining 542, venous thrombosis was demonstrated in 189 instances (prevalence, 35%; 95% confidence interval, 31% to 39%) and were located in the proximal veins in 166 (88%; 95% confidence interval, 82% to 92%) venograms. Isolated calf-vein thrombosis was present in the remaining 23 (12%; 95% confidence interval, 8% to 18%) venograms. Proximal with concurrent calf thrombosis was detected in 164 (99%) of the 166 patients. Proximal thrombi involved only the popliteal vein in 16 (10%); the popliteal and superficial femoral veins in 70 (42%); and the popliteal, superficial, and common femoral vein in eight (5%); whereas thrombi involving the entire proximal deep venous system were detected in 58 (35%) venograms. Isolated thrombosis of the superficial femoral, common femoral, and iliac vein was not observed. Proximal venous thrombi were occlusive in 146 (88%) patients. No relation between the duration of symptoms and the extent or the occlusiveness of venous thrombi could be demonstrated.Conclusions:
Most symptomatic patients have extensive occlusive proximal vein thrombosis at the time of presentation. Thrombi isolated to the superficial femoral or iliac vein were not observed in this large sample of consecutive patients. Our data support the use of the relatively simple, inexpensive, and rapid compression ultrasound method that limits the examination of the proximal veins to the common femoral and popliteal veins. (Arch Intern Med. 1993;153:2777-2780)Popliteal vein
Femoral vein
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Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study
Popliteal vein
Femoral vein
Lumen (anatomy)
Superficial vein
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Doppler ultrasound examination and radionuclide venography were performed on 82 limbs of 64 patients with a clinical diagnosis of femoral and/or popliteal vein thrombosis. Doppler ultrasound diagnosis gave positive results in 19 of 21 limbs with femoral and/or popliteal vein thrombosis. In 61 limbs without femoral or popliteal thrombosis, the diagnosis was excluded by Doppler ultrasound in 80 per cent of cases. In both groups, Doppler ultrasound was superior to physical signs in making the correct diagnosis.
Venography
Popliteal vein
Femoral vein
Doppler ultrasound
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In 54 patients with suspected deep vein thrombosis in the lower extremity, B-scan ultrasonography was compared with contrast venography for diagnostic accuracy. In the area of the common femoral/popliteal vein ultrasonography was correct in 53 patients, giving an accuracy of 98% (53/54). There were no false-negative studies, which gives a sensitivity of 100% (21/21). There was one false-positive study for a specificity of 97% (32/33). The technique is inexpensive and produces no discomfort to the patient. It is quite obvious that even small hospitals have the equipment and the competent staff to carry out this examination. We claim that B-scan ultrasonography is a certain, non-invasive method of demonstrating deep vein thrombosis in the common femoral/popliteal vein area.
Venography
Popliteal vein
Femoral vein
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Objective: To diagnose and quantitatively analyse the primary insufficiency of deep vanous valve in lower extremity(PIDVL) with color pulse Doppler(CPD) .Methods: The internal diameter of deep vein, the speed of reflux(SR) and persistent time of reflux(PTR) were measured in 39 lower extremities of 30 cases (sickness group)and 94 lower limbs of 59 cases(control group). Results: (1)The internal diameters of deep vein in lower extremities, femoral common vein, femoral shallow vein and popliteal vein in sickness group were remarkably larger than those in control group (all P0. 001) . (2) Using CPD, the PTRs of deep vein in lower limbs, femoral common vein and popliteal vein were remarkably larger than those in control group(all P 0.001) . (3) Between the 2 groups, there was not difference in the SR of deep vein in lower extremities(P 0.05). (4)The grading of PIDVL was closely related to clinical signs. Conclusion: (1)The normal value of PTR of deep vein in lower extremities is determined to be lower than 1.2 s. (2) According to the size of internal diameter and the PTR of deep vein in lower extremities, the PIDVL is classed by 3 grades.
Popliteal vein
Femoral vein
Great saphenous vein
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Objective:To investigate the diagnostic value of color Doppler ultrasound in lower limb deep vein thrombosis.Methods:With 30 cases diagnosed as deep vein thrombosis were analyzed.Results:30 cases of deep vein thrombosis were left more than right,more common one side.The preferred locations lesions followed,54.8% of the popliteal vein,38.7% of the superficial femoral vein,38.7% of the femoral vein,41.2% of the deep femoral vein,9.7% of the posterior tibial vein,6.5% of the iliac vein.No findings of the anterior tibial vein.Conclusion:As the best choice of image diagnosis,color Doppler ultrasound diagnosis of deep vein thrombosis has important clinical value.
Popliteal vein
Femoral vein
Color doppler
External iliac vein
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