Application Value Of Ultrasound Contrast Agent In Thrombolysis Diagnosis And Therapy For Acute Lower Limb Venous Thrombosis

ObjectiveThis research mainly choose patients with deep venous thrombosis as the research object,mainly to observe:1.To determine the potential of real-time contrast-enhanced ultrasound imaging in the characterization of lower extremity deep venous thrombosis(LEDVT).2.To explore the application value of microbubbles cavitation in thrombolysis therapy for acute lower limb venous thrombosis.Methods1.We conducted a prospective systematic evaluation of routine ultrasonic examination and real-time contrast—enhanced ultrasound examination by an experienced sonographers in patientsassigned for anterograde venography.The final diagnosis of LEDVT was based on anterograde venography analysis through popliteal vein.Then,we compare these diagnostic results with the results of contrast-enhanced ultrasound and conventional ultrasound examination.2.36 patients with acute lower limb venous thrombosiswere were randomly dividedinto research group(n = 20)and control group(n = 16),ultrasound-guided percutaneous popliteal vein puncture and insertion of thrombolysis catheter to common iliac vein were performed in 36 patients with lower limb deep venous thrombosis,the research group patients were injected urokinase and were performed a little contrast microbubble and ultrasound thrombolysis instrument,the control group were only injected appropriate-dose urokinase,two groups of patients were pushed note dose of contrast agent for ultrasound observation every day:two groups of patients with intravascular thrombolysis were duct contrast agents,compared with overflow cross-sectional area and measured the swelling condition of thigh and summed up treatment of days and the dosage of urokinase.Results1.A totalof 100 suspected LEDVT patients were enrolled in our study.The routine ultrasonic examination showed 74 patients were finally diagnosed with LEDVT,indeterminate in 10 cases.16 cases was diagnosed negative with LEDVT.Contrast-enhanced sonography showed 67 patients were finally diagnosed with LEDVT,5 patients were deep vein high coagulation state,28 cases was diagnosed negative with LEDVT.Anterograde venography showed 70 patients were finally diagnosed with LEDVT,and 30 case was diagnosed negative with LEDVT.2.Compared with contrast agents overflow rate of cross-sectional area,the first day were(33.30±10.01)%.(22.75±4.80)%respectively,the difference was statistically significant(t=2.66,P=0.0014<0.05);The second day were(38.20±9.07)%.(23.00±6.66)%,respectively,the difference was statistically significant(t = 3.732,P＝0.001<0.05);The time of thrombolysis were(4.65(2.75,3.00,4.00))days、(8.06(4.00,4.00,5.00))days respectively,the difference was statistically significant(U=11.50,P=0.008<0.01);Dosage of urokinase in both groups were(5.85(322.7±71.55)ten thousand U,(519.88±168.08)ten thousand U respectively,the difference was statistically significant(F=3.147,P＝0.0085<0.01);the daily change value with leg the same thigh circumference average were(1.05±0.52)cm、(0.56±0.34)cmrespectively,the difference was statistically significant(t = 3.19,P =0.003<0.05).The effect of thrombolysis therapy was satisfactory and no complication happened.ConclusionOur results showed that contrast-enhanced ultrasound imaging can be a useful imaging technique for accurate diagnosing suspected LEDVT.Microbubbles cavitation could show the promoting effect in thrombolysis therapy for acute lower limb venous thrombosis,was of good clinical application value.