XIN Yanfen 1 , PU Yingmei 1 , CHEN Yuxiang 2 , LI Jun 2 , FANG Xiang 2 , ZHANG Zujian 3
  • 1. Department of Ultrasound, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
  • 2. Department of General Surgery, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
  • 3. Department of Radiology, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
PU Yingmei, Email: pyingmei@126.com
Color Doppler ultrasonography; X-ray antegrade venography of the lower extremity; Perforating vein; Venous valve insufficiency
10.7507/1002-0179.201604235
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Objective  To investigate the value of color Doppler ultrasonography in the examination of perforating veins of the lower extremities by comparing with X-ray antegrade venography. Methods  Fifty-three patients (60 lower extremities) clinically diagnosed with varicosis of the great saphenous vein from January 2014 to March 2016 were selected for color Doppler ultrasonography and X-ray antegrade venography. The results were compared and confirmed by surgery. Results  Forty-seven lower extremities were diagnosed with perforating venous valve insufficiency by color Doppler ultrasonography, while 50 lower extremities by X-ray antegrade venography. There was no significant difference between the two methods (χ2=0.800, P=0.371). A total of 78 perforating veins were detected by color Doppler ultrasonography, with 1–4 perforating veins per one lower extremity. Among them, 66 perforating veins had an internal diameter of 2–5 mm, accounting for 84.6%. Except two perforating veins with an internal diameter <2 mm, the rest showed reflux. In addition, a total of 73 perforating veins presented distance to the pelma of 10–32 mm (foot-boot), accounting for 93.6%. Fifty-two lower extremities with varicosis of the great saphenous vein underwent laser ablation of the great saphenous vein with high ligation or + devascularization of perforating veins. Compared with operation findings, color Doppler ultrasonography in diagnosis of perforating venous valve insufficiency had 37 true positives, 2 false positives, 10 true negatives and 3 false negatives, and the sensitivity was 92.5% (37/40), the specificity was 83.3% (10/12), the accuracy rate was 90.4% (47/52). Conclusions  Color Doppler ultrasonography can accurately localize perforating veins, measure the internal diameter and observe the degree of reflux. It is of high sensitivity and accuracy in the diagnosis of perforating venous valve insufficiency. Moreover, it is safe, simple and economical, and suitable for preoperative and intraoperative diagnosis and localization.

Citation： XIN Yanfen, PU Yingmei, CHEN Yuxiang, LI Jun, FANG Xiang, ZHANG Zujian. A comparative study on color Doppler ultrasonography and X-ray antegrade venography in diagnosis of lower extremity perforating venous valve insufficiency. West China Medical Journal, 2017, 32(11): 1744-1748. doi: 10.7507/1002-0179.201604235 Copy

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