腔内超声在髂静脉受压综合征中的应用及研究进展

Application of intraluminal ultrasound in iliac vein compression syndrome and its research progress

摘要:

髂静脉受压综合征(IVCS)是指髂静脉受压、且腔内存在异常黏连结构所引起的下肢和盆腔静脉回流障碍性疾病,又称May-Thurner综合征或Cockett综合征。其不仅是造成下肢静脉瓣膜功能不全和浅静脉曲张的原因之一,也是静脉血栓好发的潜在因素。目前临床中的主要检查方式包括彩色多普勒超声(CDFI)、计算机断层扫描静脉造影(CTV)、磁共振下静脉造影(MRV)、静脉造影等,都因无法准确且便捷地评估病情而具有一定局限性。腔内超声(IVUS)对IVCS的诊断灵敏度可达90%以上,可较好显示髂静脉腔内异常结构及周围侧支,能够实时指导手术操作,是该病的理想评估方式。但因其有创性及价格昂贵,国内还鲜有报道。

Abstract:

Iliac vein compression syndrome (IVCS), also known as May-Thurner disease or Cockett′s syndrome, is venous reflux disorder in the lower limbs and pelvic caused by the compression of the iliac veins and presence of adhered structures in the pelvic cavity. It is not only one of the causes of venous valvular insufficiency and superficial varicose veins in the lower limbs, but also a potential risk factor for the occurrence of venous thrombosis. At present, the main modalities for its clinical examination include color Doppler ultrasound (CDFI), computed tomography venography (CTV), magnetic resonance venography (MRV), and venography, but they are limited for their inaccuracy and convenience in evaluating IVCS. Intravascular ultrasound (IVUS) serves as an ideal assessment method for IVUS with a diagnostic sensitivity of over 90% and ability to better display abnormal structures in the iliac vein and surrounding side branches and to provide real-time guidance during the operations. However, its application in this field is rarely reported in China due to its invasiveness and high price.