多层螺旋CT血管成像与DSA对照诊断下肢静脉阻塞性病变

Comparative diagnosis of venous occlusive diseases of lower extremity through multi-slice CT angiography and DSA

目的探讨多层螺旋CT血管成像(multi-slice CT angiography,MSCTA)在下肢静脉阻塞性病变中的应用价值。方法对32例临床疑有下肢静脉阻塞性病变患者行16层螺旋CT血管成像及血管三维重建,并进行DSA检查,结合临床资料分析CTA技术及其在下肢静脉阻塞性病变中的应用价值。结果32例疑诊下肢静脉阻塞性病变患者,MSCTA诊断髂静脉受压综合征19例,其中左侧髂总静脉受压16例,右侧髂总静脉或其分支受压3例。下肢深静脉血栓形成9例,其中左下肢2例,右下肢5例,双下肢2例。左侧腹股沟区囊肿压迫左侧髂外静脉1例。单纯左下肢浅静脉曲张1例。以上30例CT诊断结果均与DSA结果相符合。MSCTA诊断右侧股腘静脉扩张1例,未见异常1例,该2例DSA均提示下肢深静脉瓣膜功能不全。结论MSCTA对下肢静脉阻塞性病变的诊断有较高的临床应用价值。

Objective To assess the clinical application value of multi-slice CT angiography（MSCTA） in the diagnosis of venous occlusive diseases of lower extremity. Methods Thirty-two suspected patients with venous occlusive diseases of lower extremity underwent 16-slice MSCTA and DSA simultaneously. The MSCTA technique and its diagnostic value were analyzed with clinical data. Results Thirty-two cases of suspected lower extremity venous occlusive diseases were diagnosed by MSCTA, including 19 cases of iliac vein compression syndrome（left iliac vein in 16 cases, right iliac vein 3 cases）. Nine cases of deep vein thrombosis （2 on left side, 5 on fight and another 2 bilaterally）. The left external iliac vein was compressed by a cyst in left inguinal region in one case and another case showed simple varicosis of superficial veins of the left lower limb. The results were similar demonstrated by DSA and MSCTA in above thirty cases. The right femoral and popliteal venous dilatations were diagnosed by MSCTA in one case and no abnormality in the other. The two cases were found to be valvular functional defect of deep veins of lower limb by DSA. Conclusion MSCTA possesses rather high appilication value in the diagnosis of venous occlusive diseases of lower extremity.