Width of the great saphenous vein lumen in the groin and occurrence of significant reflux in the sapheno-femoral junction.
OBJECTIVE
This study was performed to assess the contribution of the width of the anechogenous lumen of the great saphenous vein (GSV) in the groin measured by ultrasound (US) to the diagnostics of haemodynamically significant reflux (HSR) in the sapheno-femoral junction (SFJ).


METHODS
We examined 200 lower limbs with primary varicose veins in 182 patients. Duplex scanning was performed with the patients in the supine position. Longitudinally imaging (B-mode) the inner anechogenous diameter of GSV was measured 4-5 cm distal to SFJ. PW Doppler sampling volume was placed at the same distance. The reflux was elicited by Valsalva manoeuvre. The HSR was defined as a backflow lasting > or = 1 s with a velocity of Vmax > or = 10 cm/s.


RESULTS
The mean width of the GSV with HSR (n=152) was 6.39 mm, median 6.0 mm, SD +/- 2.21 mm. The mean width of GSV without HSR (n = 48) was 4.41 mm, median 4.4 mm, SD +/- 0.96 mm. The difference between the mean widths of GSV was statistically significant (p < 0.01). In GSV < 5 mm (n = 77) HSR (V max > or = 10 cm/s) was confirmed in 46 cases (59.7 %), in GSV > or = 5 mm (n = 123) in 106 cases (86.2 %). The sensitivity of dilatation of GSV > or = 5 mm for the presence of HSR in SFJ was 69.7 %, specificity 64.6 %. PPV (positive predictive value) of dilatation of GSV > or = 5 mm for the presence of HSR in SFJ was 86.2 %, NPV (negative predictive value) was 40.3 %, and the diagnostic accuracy of dilatation of GSV > or = 5 mm was 68.5 %.


CONCLUSIONS
Measurement of anechogenous lumen GSV under the groin in B-mode is less sensitive (69.7 %) and less specific (64.6 %) in the diagnostics of HSR in SFJ. Only 68.5 % of all measurements of the width of the GSV below the groin in B-mode provided accurate indirect assessment of the functions of valves in SFJ. US scanning of the width of anechogenous lumen of GSV below the groin may serve only for ancillary examination.
Musil
Dalibor
D
Vascular Ambulance and Department of Pathophysiology, Palacky University Olomouc, Czech Republic. musil.dalibor@quick.cz
Herman
Jiri
J
Mazuch
Julius
J
D005260:Female; D006119:Groin; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000175:diagnosis / Q000000981:diagnostic imaging*