Value of Contrast-Enhanced Ultrasound in Detecting Competent and Incompetent Lower-Extremity Perforating Veins

Abstract The purpose of this study was to investigate the value of contrast-enhanced ultrasound (CEUS) in the identification of competent and incompetent lower-extremity perforating veins. Patients with chronic venous insufficiency who met the inclusion criteria were enrolled. All patients underwent pre-operative CEUS and color Doppler ultrasound (CDU) and accepted subfascial endoscopic perforator surgery. We compared the numbers of perforator veins identified by CEUS and CDU with the endoscopy result, which was considered the gold standard. Fifty cases (56 lower extremities) were enrolled. CEUS detected 132 perforating veins, and CDU detected 104 perforating veins. Endoscopy detected 148 perforating veins. The sensitivity and specificity of CDU in predicting the site of perforating veins in our study were 70.2% and 100%, respectively, and the sensitivity and specificity of CEUS were 89.2% and 100%, respectively ( p  0.05). CEUS could be used to detect perforating veins, including incompetent and competent veins of the lower extremity, because it was more sensitive than CDU, with intra-operative endoscopy as the control standard.