直接法MSCTV对下肢深静脉梗阻性病变的诊断价值

目的 探讨双筒双流直接法多层螺旋CT静脉造影(MSCTV)对下肢深静脉梗阻性病变的诊断价值.方法 对临床高度怀疑下肢深静脉梗阻性病变的100例患者进行双筒双流直接法MSCTV,将重建的薄层图像数据导入后处理工作站行最大密度投影(MIP),多平面重组(MPR)及容积重建(VR)等,分析下肢深静脉梗阻性病变的影像学表现并进行图像质量分级.所有患者均在直接法MSCTV 1周内进行数字减影血管造影(DSA)检查.结果 直接法MSCTV显示100例患者双侧下肢深静脉重组图像显示清晰,重组血管对比度良好.双下肢深静脉显示情况质量分级:下腔静脉优占95％、髂总静脉优占94％、髂外静脉优占95％、股静脉优占95.5％、胭静脉优占96.5％、小腿静脉优占92％.100例患者中8例正常,92例显示不同部位、不同程度的静脉梗阻(其中多发性静脉梗阻64例,单发性梗阻28例).下肢深静脉梗阻部位:下腔静脉3支,髂总静脉67支,髂外静脉28支,股静脉50支,腘静脉26支,胫前静脉89支,胫后静脉35支,腓静脉5支.DSA显示100例患者中7例正常,93例显示不同部位、不同程度的下肢深静脉梗阻.结论 直接法MSCTV可准确地显示下肢深静脉梗阻的情况,明确下肢深静脉梗阻的原因,图像清晰度及可靠性高,可明确病灶的范围和程度及侧支循环的建立与否,有重要临床应用价值.

The diagnostic value of direct MSCTV for lower extremity deep venous obstructive disease

Objective To explore the diagnostic value of dual syringe and dual-channel direct multi-slice computed tomography venography(MSCTV) for lower extremity deep venous obstructive disease.Methods 100 patients highly suspected deep vein thrombosis by clinic wereunderwent dual syringe and dual-channel direct MSCTV.The original data processed with technology of subtraction,and put into workstation and reconstructed with maximum intensity projection(MIP),multiplanar reformation(MPR) and volume rendering (VR).Images of deep venous obstructive lesions were analysed and graded.All patients were underwent DSA in one week.Results Direct MSCTV showed that the reconstructed images and the vascular contrast were very clear.In the evaluation of deep venous,excellent proportion was 95 ％ for the inferior vena cava,94 ％ for the common iliac vein,95 ％ for the external iliac vein,95.5 ％ for the femoral vein,96.5％ for the popliteal vein and 92 ％ for the low leg vein.Direct MSCTV displayed complete and regular vein in 8 normal patients,92 cases displayed different parts and different degrees of thrombosis.On original axial images,eccentric filling defect of vascular were showed (there were 64 multiple vein occlusion cases and 28 solitary obstruction cases).The occlusion locations in deep venous were as following:3 in the inferior vena cava,67 in the common iliac vein,28 in the external iliac vein,50 in the femoral vein,26 in the popliteal vein,89 in the anterior tibial vein,35 in the posterior tibial vein and 5 in the peroneal vein.There were 7 normal patients and 93 patients with different parts and different degrees of thrombosis.Conclusion Direct MSCTV can accurately show deep vein thrombosis,which image is clear and reliable for displaying the scope and extent of lesions of the vascular and whether the collateral circulation established.Direct MSCTV has a significant clinical value in diagnosing the thrombotic disease of deep vein obstructive lesions.