64排螺旋CT静脉造影诊断下肢静脉血栓性病变

目的:探讨64排螺旋CT静脉造影(CTV)诊断下肢静脉血栓性病变的临床价值。材料和方法:下肢多层螺旋CT静脉造影(MSCTV)检查12例,同期均做下肢静脉Dopp ler超声(US)检查;其中1例同时进行了肺动脉CT血管造影,并于延迟2m in时行间接法下肢静脉造影检查。病例均采用5mm层厚和层间距行踝关节至髂骨上缘水平的增强CT扫描,并获得原始图像,图像经1.25mm层厚和50%的重叠处理后传送至工作站进行图像后处理。结果:64排螺旋CTV诊断下肢深静脉血栓(DVT)11例,诊断下肢慢性静脉功能不全1例,同时合并肺栓塞1例。以US作对照,64排螺旋CTV显示股静脉和腘静脉血栓的敏感性为100%,特异性98.6%。MSCTV上DVT表现为静脉腔内不规则低密度充盈缺损,慢性静脉功能不全表现为深静脉边缘不规则且于延迟2m in扫描见其远端引流静脉区造影剂点状残留。结论:64排螺旋CTV在显示股腘静脉血栓与US具有同等价值,MSCTV可作为下肢静脉血栓性病变诊断的常规检查方法。

64 Multi-Detector CT Venography in Diagnosing Thromboembolic Disease of the Lower Extremeties

Purpose: To evaluate the clinical application of 64 multi-detector CT venography(CTV) in detecting venous thromboembosis of the lower extremities.Materials and Methods: On 64 multi-slice CT scanner,11 patients underwent direct CTV of the lower extremities and 1 patient underwent indirect CTV 2 min after pulmonary angiography.Doppler ultrasound was taken as reference.Results: Deep venous thrombosis(DVT) of lower extremity were detected in 11 patients,showing irregular hypodense filling defects on CTV images.1 patient with chronic venous dysfunction was revealed on CTV images,showing irregular border on the deep vein and dotted contrast staining on its distal segment during delay scan.When compared with Doppler ultrasound,the sensitivity and specificity of CTV in detecting femoropopliteal deep venous thrombosis was 100% and 98.6%,respectively.Conclusion: 64 multi-detector CTV has the same capability in detecting femoropopliteal deep venous thrombosis and can be an alternation of conventional venography diagnosing DVT of the lower extremity.