The Significance Of Ultrasonography In The Diagnosis Of Iliac Vein Compression Syndrome

Objective:To explore the significance of Ultrasonography in the diagnosis of iliac vein compression syndrome(IVCS,also known as May-Thurner Syndrome,MTS).Methods:The affected iliac veins and ipsilateral lower extremity veins of CVD and DVT inpatients in our hospital from January 2016 to January 2019 were examined by ultrasound within one week before DSA.According to the results of DSA,the affected limbs were divided into MTS group and non-MTS group,the significance of three ultrasonic indexes(iliac vein stenosis or occlusion,collateral circulation formation and the reflux of internal iliac vein)in the diagnosis of MTS was analyzed.According to the ultrasonic results,the affected limbs were divided into "MTS" and "non-MTS" groups.The correlation between MTS and non-thrombotic CVD or DVT was analyzed according to the results of DSA and ultrasound.Results:1.Analysis of General data between MTS Group and non-MTS Group In the MTS group,the proportion of female affected limbs was higher than that in the non-MTS group,and the average age was lower than that in the non-MTS group,there was significant difference in the sex ratio between the two groups,but there was no significant difference in the average age.The proportion of young limbs in MTS group was higher than that in non-MTS group,while the proportion of middle-aged and elderly was lower than that in non-MTS group,there was significant difference between the two groups.2.Correlation Analysis of Ultrasonic Indexes in the diagnosis of MTS Iliac vein stenosis(or occlusion)and collateral circulation formation were the risk factors of MTS,while the reflux of internal iliac vein was not related to MTS.3.Accuracy Analysis of Ultrasound in the diagnosis of MTS Ultrasound can diagnose MTS if it satisfies either "iliac vein stenosis(or occlusion)" or "collateral circulation formation",the sensitivity,specificity and accuracy of ultrasound in the diagnosis of MTS were 94.90%,82.64% and 85.95%,respectively.4.Correlation Analysis between MTS and non-thrombotic CVD or DVT The proportion of DVT in MTS group was higher than that in non-MTS group,while the proportion of non-thrombotic CVD in MTS group was lower than that in non-MTS group,there was significant difference between the two groups.Ultrasound can diagnose MTS if it satisfies either "iliac vein stenosis(or occlusion)" or "collateral circulation formation",and the results obtained by ultrasound were consistent with the above results.For different grades of CVD limbs: compared with the non-MTS group,the proportion of C3 and C5 CVD limbs in MTS group was higher,and the proportion of C2,C4,C6 CVD limbs was lower,the difference between the two groups was statistically significant.Ultrasound can diagnose MTS if it satisfies either "iliac vein stenosis(or occlusion)" or "collateral circulation formation",the results of ultrasound showed that compared with the “non-MTS” group,the proportion of C2,C3,C5 CVD limbs in “MTS” group was higher,and the proportion of C4 and C6 CVD limbs was lower,there was significant difference between the two groups.The results of ultrasound and DSA were slightly different,and the difference was concentrated in the proportion of C2 CVD limbs.Conclusion:Young women have a higher risk of MTS;iliac vein stenosis(or occlusion)and collateral circulation formation are reliable indicators for ultrasonic diagnosis of MTS;MTS combined with DVT is easier to detect by image examination.