CT血管成像在髂静脉受压综合征及继发血栓形成中的诊断价值

Diagnosis value of CT angiography in the iliac vein compression syndrome and secondary thrombosis

目的:探讨CT血管成像(CTA)对髂静脉受压综合征(IVCS)及继发血栓形成的诊断价值。方法:选择本院2008年2月～2010年10月收治的髂静脉受压综合征患者26例(研究组),均经下肢静脉血管造影检查证实;选择同期行下腹部及盆腔CTA检查的患者30例(对照组),比较两组髂静脉内径及受压程度,并以DSA为标准评价CTA检查髂静脉受压的准确性。结果:研究组患者受压髂静脉前后内径为(2.6±1.2)mm,对照组患者对应髂静脉前后内径为(7.5±1.4)mm,两组比较差异有统计学意义(t=12.36,P<0.05);研究组患者髂静脉受压程度中位数为75.5%,对照组对应髂静脉受压程度中位数为24.7%,两组比较差异有统计学意义(P<0.05)。CTA诊断研究组26例患者中,左髂总静脉受压23例,右髂静脉受压3例,其中12例患者继发血栓形成,与DSA检查结果一致。结论:CTA检查可以准确显示受压髂静脉内径及受压程度,可清楚显示继发血栓情况,与DSA检查的一致性较高,并且无创伤,费用较少,值得应用。

Objective： To evaluate diagnosis value of CT angiography （CTA） in the iliac vein compression syndrome （IVCS） and secondary thrombosis. Methods： 26 cases of IVCS patients confirmed by DSA in our hospital from February 2008 to October 2010 were selected as study group and 30 cases of patients with lower abdominal and pelvic CTA were as control group; Inner diameter and pressure level of the iliac vein were compared, accuracy of CTA was evaluated with standard of DSA. Results： The inner diameter of study group and control group was （2.6±1.2）mm, （7.5±1.4）mm, the difference was statistically significant （t=12.36, P〈0.05）; median of press level in two group was 75.5% and 24.7%, the difference was statistically significant （P〈O.05）. In study group, 23 cases were diagnosed of left iliae vein compression by CTA, 3 cases were right iliac vein compression, 12 patients were with secondary thrombosis, and the results was consistent with DSA findings. Conclusion： CTA examination can accurately show the inner diameter and pressure level of the iliae vein, show the situation of secondary thrombosis clearly, and the consistency with DSA is higher; in addition it has no invasive, less expensive, and should be applied.