下肢静脉超声检出肌肉骨骼系统病变的临床价值
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摘要
目的探讨下肢静脉超声检出肌肉骨骼系统病变的临床价值。方法回顾性收集因临床疑诊或需除外下肢深静脉血栓接受下肢静脉超声检查的8 288例患者的资料,分析下肢静脉超声检查对于肌肉骨骼系统病变的检出率及合并深静脉血栓等超声表现。结果下肢静脉超声检出肌肉骨骼系统病变134例,以腘窝囊肿(90/134,67.16%)最常见,其后依次为血肿(31/134,23.13%)、肌肉撕裂(5/134,3.73%)、脓肿(2/134,1.49%)、肿瘤(2/134,1.49%)、肌层囊肿(2/134,1.49%)、腘窝术后积液(1/134,0.75%)及膝关节滑膜增生(1/134,0.75%)。不同肌肉骨骼系统病变超声表现各异。腘窝未破裂囊肿最大径大于破裂囊肿(F=5.266,P=0.024)。134例中20例合并下肢深静脉血栓,其中肌肉撕裂患者最易合并血栓(1/5,20.00%)。结论下肢静脉超声检查可在判别有无深静脉血栓的同时检出肌肉骨骼系统病变,有助于修正或补充临床诊断及治疗方案,具有较高临床价值。
Objective To explore the clinical value of detection of musculoskeletal diseases during lower extremity venous ultrasonography.Methods Data of 8 288 patients who underwent venous ultrasonography of the lower extremities suspected for venous thrombosis were retrospectively analyzed.Ultrasonic images for detection of musculoskeletal diseases and coexisting deep venous thrombosis were analyzed.Results There were 134 patients with musculoskeletal diseases detected with lower extremity venous ultrasonography.Popliteal cyst was the most common musculoskeletal disease(90/134,67.16%),followed by hematoma(31/134,23.13%),muscle tear(5/134,3.73%),abscess(2/134,1.49%),tumor(2/134,1.49%),muscular cyst(2/134,1.49%),postoperative popliteal effusion(1/134,0.75%)and knee synovial hyperplasia(1/134,0.75%).Different musculoskeletal diseases showed different ultrasonic manifestations.The maximum diameter of not-ruptured popliteal cyst was larger than that of ruptured cyst(F=5.266,P=0.024).A total of 20 patients had deep venous thrombosis.The highest rate of coexisting deep venous thrombosis was found in patients with muscle tear(1/5,20.00%).Conclusion Lower extremity venous ultrasonography can be used to diagnose deep venous thrombosis and musculoskeletal diseases simultaneously.The detection of musculoskeletal diseases during venous ultrasonography of lower extremities is helpful to correct or supplement the clinical diagnosis and the following treatment,which has high clinical application value.
Objective To explore the clinical value of detection of musculoskeletal diseases during lower extremity venous ultrasonography.Methods Data of 8 288 patients who underwent venous ultrasonography of the lower extremities suspected for venous thrombosis were retrospectively analyzed.Ultrasonic images for detection of musculoskeletal diseases and coexisting deep venous thrombosis were analyzed.Results There were 134 patients with musculoskeletal diseases detected with lower extremity venous ultrasonography.Popliteal cyst was the most common musculoskeletal disease(90/134,67.16%),followed by hematoma(31/134,23.13%),muscle tear(5/134,3.73%),abscess(2/134,1.49%),tumor(2/134,1.49%),muscular cyst(2/134,1.49%),postoperative popliteal effusion(1/134,0.75%)and knee synovial hyperplasia(1/134,0.75%).Different musculoskeletal diseases showed different ultrasonic manifestations.The maximum diameter of not-ruptured popliteal cyst was larger than that of ruptured cyst(F=5.266,P=0.024).A total of 20 patients had deep venous thrombosis.The highest rate of coexisting deep venous thrombosis was found in patients with muscle tear(1/5,20.00%).Conclusion Lower extremity venous ultrasonography can be used to diagnose deep venous thrombosis and musculoskeletal diseases simultaneously.The detection of musculoskeletal diseases during venous ultrasonography of lower extremities is helpful to correct or supplement the clinical diagnosis and the following treatment,which has high clinical application value.
引文
[1] 胡竞,江峰,胡骥琼.超声引导置管溶栓治疗下肢深静脉血栓.中国介入影像与治疗学,2014,11(2):73-76.
[2] Lowe G, Tait C. Limb pain and swelling. Medicine, 2009,37(2):96-99.
[3] Shah A, James SL, Davies AM, et al. A diagnostic approach to popliteal fossa masses. Clin Radiol, 2017,72(4):323-337.
[4] Sanchez JE, Conkling N, Labropoulos N. Compression syndromes of the poplitealneurovascular bundle due to Baker cyst. J Vasc Surg, 2011,54(6):1821-1829.
[5] Kabeya Y, Tomita M, Katsuki T, et al. Pseudothrombophlebitis. Intern Med, 2009,48(21):1927.
[6] Ozgocmen S, Kaya A, Kamanli A, et al. Rupture of Baker's cyst producing pseudothrombophlebitis in a patient with Reiter's syndrome. Kaohsiung J Med Sci, 2004,20(12):600-603.
[7] Herman AM, Marzo JM. Popliteal cysts: A current review. Orthopedics, 2014,37(8):e678-e684.
[8] Schimizzi AL, Jamali AA, Herbst KD, et al. Acute compartment syndrome due to ruptured Baker cyst after nonsurgical management of an anterior cruciate ligament tear: A case report. Am J Sports Med, 2006,34(4):657-660.
[9] 魏小龙,赵志青,景在平.小腿血肿误诊为深静脉血栓临床分析(附37例报告).临床外科杂志,2010(5):348-349.
[10] Pacheco RA, Stock H. Tennis leg: Mechanism of injury and radiographic presentation. Conn Med, 2013,77(7):427-430.
[11] Bright JM, Fields KB, Draper R. Ultrasound diagnosis of calf injuries. Sports Health, 2017,9(4):352-355.
[12] Delgado GJ, Chung CB, Lektrakul N, et al. Tennis leg: Clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiology, 2002,224(1):112-119.
[2] Lowe G, Tait C. Limb pain and swelling. Medicine, 2009,37(2):96-99.
[3] Shah A, James SL, Davies AM, et al. A diagnostic approach to popliteal fossa masses. Clin Radiol, 2017,72(4):323-337.
[4] Sanchez JE, Conkling N, Labropoulos N. Compression syndromes of the poplitealneurovascular bundle due to Baker cyst. J Vasc Surg, 2011,54(6):1821-1829.
[5] Kabeya Y, Tomita M, Katsuki T, et al. Pseudothrombophlebitis. Intern Med, 2009,48(21):1927.
[6] Ozgocmen S, Kaya A, Kamanli A, et al. Rupture of Baker's cyst producing pseudothrombophlebitis in a patient with Reiter's syndrome. Kaohsiung J Med Sci, 2004,20(12):600-603.
[7] Herman AM, Marzo JM. Popliteal cysts: A current review. Orthopedics, 2014,37(8):e678-e684.
[8] Schimizzi AL, Jamali AA, Herbst KD, et al. Acute compartment syndrome due to ruptured Baker cyst after nonsurgical management of an anterior cruciate ligament tear: A case report. Am J Sports Med, 2006,34(4):657-660.
[9] 魏小龙,赵志青,景在平.小腿血肿误诊为深静脉血栓临床分析(附37例报告).临床外科杂志,2010(5):348-349.
[10] Pacheco RA, Stock H. Tennis leg: Mechanism of injury and radiographic presentation. Conn Med, 2013,77(7):427-430.
[11] Bright JM, Fields KB, Draper R. Ultrasound diagnosis of calf injuries. Sports Health, 2017,9(4):352-355.
[12] Delgado GJ, Chung CB, Lektrakul N, et al. Tennis leg: Clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiology, 2002,224(1):112-119.