DIAGNOSIS OF PORTAL-VEIN THROMBOSIS - VALUE OF COLOR DOPPLER IMAGING
DIAGNOSIS OF PORTAL-VEIN THROMBOSIS - VALUE OF COLOR DOPPLER IMAGING
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DOI：
10.2214/ajr.157.2.1853809
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发表时间：
1991-08-01
影响因子：
5
通讯作者：
GRANT, EG
中科院分区：
文献类型：
--
作者：
TESSLER, FN;GEHRING, BJ;GRANT, EG
本研究旨在探讨彩色多普勒超声诊断门静脉血栓形成的准确性。215例患者进行了彩色多普勒成像，以确定门静脉主干的通畅性。超声检查结果证实了75例患者，年龄19至66岁。13例患者与血管造影相关，其余62例患者与手术相关。根据这些金标准，9例患者发生门静脉血栓形成。根据显示门静脉主干内彩色血流的能力，将超声图像分为显示通畅性或血栓形成。69例患者（61例患者，8例血栓形成）超声检查和血管造影或手术之间的一致性。超声检查门静脉通畅的1例患者在手术时发现血管血栓形成，而超声检查无门静脉血流的5例患者在血管造影（1例患者）或手术（4例患者）时血管通畅。检测门静脉血栓形成的总体敏感性和特异性分别为89%和92%，准确性为92%，假阴性率为0.11，阴性预测值为0.98，阳性预测值为0.62。我们假设，在我们的研究中，大多数错误发生在血管，虽然专利，只有缓慢的流动，这不能解决，因为技术的局限性，我们得出结论，彩色多普勒成像是一个有价值的筛选程序评估门静脉通畅。如果超声图显示门静脉通畅，则无需进一步检查。然而，缺乏可证实的血流并不总是表明血栓形成，应进行其他影像学检查进行确认。
This study was undertaken to determine the accuracy of color Doppler imaging in the diagnosis of portal vein thrombosis. Two hundred fifteen patients were studied with color Doppler imaging to determine patency of the main portal vein. Sonographic findings were confirmed in 75 patients, aged 19 to 66 years. Correlation with angiography was obtained in 13 patients, and surgical correlation was obtained in the remaining 62. Nine patients had portal vein thrombosis on the basis of these gold standards. Sonograms were classified as showing either patency or thrombosis, depending on the ability to show color flow within the main portal vein. Agreement between sonography and angiography or surgery was found in 69 patients (61 patent, eight thrombosed). One patient with a patent portal vein at sonography was found to have a thrombosed vessel at surgery, whereas five patients without portal venous flow at sonography had patent vessels at angiography (one patient) or surgery (four patients). Overall sensitivity and specificity for detection of portal vein thrombosis were 89% and 92%, with an accuracy of 92%, a false-negative rate of 0.11, a negative predictive value of 0.98, and a positive predictive value of 0.62. We postulate that the majority of errors in our study occurred in vessels that, although patent, had only sluggish flow, which could not be resolved because of technical limitations.We conclude that color Doppler imaging is a valuable screening procedure for the assessment of portal vein patency. If the sonogram shows a patent portal vein, no further studies are required. However, a lack of demonstrable flow does not always indicate thrombosis, and other imaging studies should be performed for confirmation.