SANTRAUKAReikšminiai žodžiai: giliųjų venų trombozė, kompresinis ultragarsinis tyrimas, daugiasluoksnė kompiuterinė tomografija, magnetinis rezonansas, venografija. Venų tromboembolija (VTE) -tai dvi tarpusavyje susijusios patologijos: plaučių embolija (PE) ir giliųjų venų trombozė (GVT). Giliųjų venų trombozė išlieka svarbi sveikatos sistemos problema, kadangi yra susijusi su komplikacijomis, turinčiomis aukštą sergamumo ir mirtingumo rodiklį: ūminė ir lėtinė plaučių embolijos, plautinė hipertenzija ir potrombozinis sindromas. Paprastai GVT prasideda blauzdos venose, bet gali tęstis proksimaliau ir sąlygoti gyvybei pavojingą plaučių emboliją. Klinikinėje praktikoje labai svarbi šios ligos profilaktika ir gydymas, tad aktuali yra ankstyva ir tiksli diagnozė, įvertintant tikslią GVT vietą ir apimtį. Apibendrinus literatūros duomenis, straipsnyje apžvelgiami radiologinės diagnostikos metodai kojų giliųjų venų trombozei nustatyti, radiologinių tyrimų privalumai ir trūkumai.
ABSTRACTKey words: deep vein thrombosis, compression ultrasound, multidetector computed tomography, magnetic resonance, venography. Venous thromboembolism consists of two related conditions: deep vein thrombosis and pulmonary embolism. One-third venous thromboembolism cases are manifested as pulmonary embolism and two-third present with deep vein thrombosis alone. Deep venous thrombosis remains an important health care problem as it is related with the complications having a high morbidity and mortality rate: acute and chronic pulmonary embolism, pulmonary hypertension and post-thrombotic syndrome. It is considered the third most common acute cardiovascular disease after ischemic heart disease and stroke and effects millions of people worldwide. Conventional venography was the gold standard in deep vein thrombosis diagnosis and the only imaging test for a long time in order to specify the suspected deep vein thrombosis in legs, pelvis or inferior vena cava [1,2]. Presently contrast x-ray venography is applied very seldom in conventional medical practice. Contrast x-ray venography is particularly helpful for assessing recurrent acute deep vein thrombosis in patients with a prior history of deep vein thrombosis in whom venous anatomy is often complex and difficult to evaluate using other methods [3] or when to remove an inferior vena cava filter. Conventional venography is presently replaced with non-invasive or less invasive radiological examination methods: the firstchoice method is ultrasound, but there are also other ones -computed tomography venography and magnetic resonance venography. Ultrasound is the imaging examination of choice for suspected lower extremity deep venous thrombosis. Ultrasound has high sensitivity (range, 93.2 %-95.0 %; pooled sensitivity, 94.2 %) and high specificity (range, 93.1 %-94.4 %; pooled specificity, 93.8 %) for diagnosing proximal (thigh) deep vein thrombosis and much lower sensitivity (range, 59.8 %-67.0 %; pooled sensitivity, 63.5 %) for diagnosing distal (calf ) and pelvic veins thrombosis. Compression ultra...