超音波検査法による脳卒中後重度片麻痺患者における下肢静脈血栓の検討

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We evaluated the incidence of deep vein thrombosis (DVT) in patients with hemiplegia after stroke using ultrasonography.Thirty patients with post-stroke hemiplegia (Brunnstrom stage 1-2) were enrolled. We evaluated clinical signs of DVT, ultrasonographic findings and D-dimer an average of 19.1 days after onset. Ultrasonographic findings were classified into three groups: (1) DVT: visualization of an intraluminal thrombus, lack of venous compressibility, and lack of signal on the color flow image. (2) Moyamoya-echo: intraluminal high echo signal with venous compressibility. (3) Normal findings.Nine patients (30%) had direct findings of DVT in the affected lower extremity. Six had proximal and three had calf DVT. Two of nine had DVT in the non-affected lower extremity. Moyamoya-echo was seen in six patients (20%). Patients with DVT and moyamoya-echo were older than patients with normal findings. D-dimer assays of patients with DVT showed higher values compared with moyamoya-echo and normal findings. Patients with hemiplegia after stroke were candidates at high risk of DVT. Ultrasonography was useful for screening of DVT. We think that Moyamoya-echo is a precursor sign of DVT.