多层螺旋CT静脉造影诊断下肢静脉血栓性病变

Multislice CT venography in diagnosing venous thrombosis of lower extremity

目的 探讨多层螺旋CT静脉造影 (MSCTV)对下肢静脉血栓诊断的临床应用价值。方法 MSCT下肢静脉造影检查 16例 ,其中 12例做下肢多普勒超声检查 ,4例做下肢静脉造影。MSCTV检查后经最大密度投影 (MIP)、表面遮盖法(SSD)及容积再现法 (VR)重建。结果 MSCTV显示 11例存在静脉血栓。以多普勒超声作对照 ,MSCTV显示股静脉血栓的敏感性 96.0 % ,特异性 97.8% ,阳性预测值 96.0 % ,阴性预测值 97.8% ,准确性 97.2 %。MSCT尚能显示小腿、盆腔等超声检查难于显示的血栓。MSCTV较常规静脉造影更清晰显示盆腔静脉血栓。结论 MSCTV对显示股静脉血栓方面与超声同样敏感 ,MSCTV还能显示超声难于显示的髂静脉及胫腓静脉的血栓。MSCTV可作为下肢静脉血栓诊断的首选检查方法。

Objective To evaluate diagnostic value of multislice CT venography (MSCTV) in detecting venous thrombosis of the lower extremity. Methods Sixteen patients underwent MSCTV, from which 12 patients were examined by venous sonography (US), and 4 patients by conventional venography within 1 week. The data of MSCTV were reconstructed with maximum intensity projection (MIP), shade surface displayment (SSD) and volume rendering (VR). Results Venous thrombosis was revealed by MSCTV images in 11 patients. Comparing MSCTV with US in the evaluation of femoropopliteal deep venous thrombosis, the sensitivity measured 96.0%; specificity, 97.8%; positive predictive value, 96.0%; nagative predictive value, 97.8%; and accurcy, 97.2%. Venous thrombosis in pelvic and calf was revealed on CT image, which was poorly shown on sonography. MSCTV demonstrated that deep venous thrombosis extended into pelvic vein more clearly than conventional venography. Conclusion MSCTV is as sensitive as US in evaluating femoropopliteal deep venous thrombosis. Moreover the iliac veins and calf veins, that poorly shown on songraphy, are also depicted by MSCTV. MSCTV may be used as a first selective technique in diagnosing venous thrombosis of the lower extremity.