螺旋CT静脉血管造影对髂股静脉阻塞性病变的诊断价值

Clinical Applicational Value of Iliac-femur Venous Obstructive Diseases with Spiral Computed Tomography Venography

目的 探讨螺旋 CT静脉造影 ( SCTV)对下肢静脉阻塞性疾病的临床应用价值。方法 用 SCTV诊断髂股静脉血栓形成 2 6例 ,经双下肢足背静脉穿刺顺行性 SCT静脉血管造影 ,造影剂注射速度为 2 .0 ml/s,延迟扫描时间为 15～ 18s,螺距 1.5mm,图像后处理选用层厚 2 .7mm,层间距 1.2～ 2 .0 mm,应用 MIP和 SSD进行血管成像。结果 SCTV清楚地显示出了下肢静脉血管梗阻性病变的部位、范围以及侧支循环情况。下肢静脉阻塞性病变的 SCTV表现 :1静脉血管中断或纤细 ,血管腔狭窄、血管闭塞 ;2股浅静脉侧支静脉血管扩张、迂曲、呈串珠状改变 ;3在横断面上血管腔内充容缺损和血管壁增厚。 4肢体软组织增厚 ,密度不均匀 ,皮下软组织内静脉血管扩张迂曲、增多、增粗。结论 SCT髂股静脉造影对下肢深部静脉以及盆腔静脉血栓的诊断有较高的敏感性和特异性 ,横断面原始图像可直接显示静脉血栓 ,完全可以替代下肢深静脉造影。

Objective To evaluate clinical diagnostic value of iliac-femur vein-blocking diseases with spiral computed tomography tomography (SCTV).Method From 1998.6 to 2000.6,26 patients with iliac-femur vein-blocking diseases were examined with SCTV by authors.It was 21 males and 5 females(mean 52).All patients were undergone spiral computed tomographic venography of Iliac-femur Vein with MIP and SSD technique.Result The authors discovered 26 cases of venous thrombosis including 3 case of right iliac vein thrombus,15 cases of right femural vein thrombus,3 cases of right femural venous thrombosis and stenosis,3 cases of left femural vein thrombosis,2 cases of left femural vein traumaed stenosis and occlusion.On SCTV images,sensitivity and specificity of revealing iliac-femur venous obstructive diseases was individually 100%.Conclusion SCT venography can provide important information for venous obstructive diseases of lower limbs.It is a safe,noninvasive,reliable,and very usueful method of which may replace conventional venography of lower limbs in diagnosising obstructive phlebosis. [