探讨超声对左下肢深静脉血栓(DVT)合并Cockett综合征的诊断价值。

回顾分析经数字减影血管造影(DSA)确诊的123例左下肢DVT患者的声像图表现，根据DSA结果将其分为Cockett综合征组和非Cockett综合征组；测量两组患者左髂总静脉近心端内径d1和血流速度v1、远心端内径d2和血流速度v2，并计算d2/d1和v1/v2比值，进行统计学分析。

123例患者，Cockett综合征78例，超声正确诊断70例，漏诊8例，超声诊断Cockett综合征的准确度、敏感度、特异度分别为93.5%、89.7%、100.0%，与DSA比较两者具有一致性(Kappa＝0.865)。Cockett综合征组患者左侧髂总静脉近心端内径d1[(2.1±0.3)mm]较非Cockett综合征组[(5.0±0.6)mm]明显变小，流速度v1[(79.3±19.2)cm/s]较非Cockett综合组[(38.9±13.1)cm/s]较快，差异有统计学意义(t＝6.22，5.83；P<0.01)。若以d1＝2.1 mm或v1/v2＝6.0作为诊断Cockett综合征的分层指标，其准确度、敏感度、特异度分别为76.8%、71.3%、83.6%，77.4%、74.5%、82.6%。

超声是诊断左下肢DVT合并Cockett综合征的可靠方法，可以为临床确诊该病提供重要的影像学依据，具有重要的临床意义。

To explore the value of ultrasound diagnosis of exploring the deep vein thrombosis (DVT) of left lower extremity complicated with Cockett syndrome.

The sonographic appearances of 123 patients with DVT of left lower extremity were analyzed retrospectively and they were divided into Cockett syndrome group and non Cockett syndrome group (control group) based on the result of DSA.The inner diameter, flow velocity of proximal vessel (d1, v1), distal vessel (d2, v2) of left iliac vein, calculated the ratio of d2/d1 and v1/v2 were calculated.

Seventy-eight cases were diagnosed as Cockett syndrome by DSA, 70 of them were detected by ultrasound.The accuracy, sensitivity and specificity of Cockett syndrome by ultrasound were 93.5%, 89.7% and 100.0% respectively.The result of ultrasound demonstrated well coherence (Kappa=0.865) of the diagnosis of DSA.Compared with the control groups, a significant reduction of inner diameter [d1, (2.1±0.3)mm] as well as an increase in flow velocity [v1, (79.3±19.2)cm/s] was observed in the proximal vessel of left iliac vein in the Cockett syndrome group(t=6.22, 5.83; P<0.01). The d1 (2.1 mm) or v1/v2 (6.0) used as the indicator for diagnosing Cockett syndrome, the accuracy, sensitivity and specificity were 76.8%, 71.3%, 83.6% and 77.4%, 74.5%, 82.6% respectively.

Ultrasound is a reliable method for the diagnosis of the DVT of left lower extremity complicated with Cockett syndrome, which has great significance for clinical diagnosis and treatment.