多模态CT静脉造影在静脉腔内激光治疗联合泡沫硬化杂交手术中的应用  

Multimodal CT Venography Imaging in Hybrid Operation of Endovenous Laser Treatment and Foam Sclerosant Ablation for Patients with Lower Extremity Varicosity

作　　者：钱丽霞[1] 严俭 黄虹[1] QIAN Lixia;YAN Jian;HUANG Hong(Department of Interventional Radiology,Wuxi Third People′s Hospital,Wuxi 214041,China)

机构地区：[1]无锡市第三人民医院放射科,江苏无锡214041

出　　处：《医学综述》2018年第17期3520-3524,共5页Medical Recapitulate

摘　　要：目的探讨多模态CT静脉造影(CTV)在静脉腔内激光治疗(EVLT)联合泡沫硬化杂交手术治疗下肢静脉曲张治疗中的应用价值。方法回顾性分析2010年1月至2014年4月无锡市第三人民医院放射科收治的96例原发性大隐静脉曲张患者共156侧患肢的相关资料,均实施EVLT联合泡沫硬化杂交手术,术前及术后3个月行多模态CTV评估病变血管情况。结果 96例患者(156侧患肢)术前多模态CTV下肢静脉曲张检出率及诊断准确率均为100%,其中轻度35例(22.43%),中度58例(36.71%),重度63例(39.87%)。术前VR及横断图像分析质量分级优94.87%(148/156)、中5.12%(8/156)。穿支静脉总显示率为98.71%(154/156),图像质量满足诊断(优+中)的比率为94.23%(147/156)。小腿静脉、股静脉、髂外静脉显示率分别为99.35%(155/156)、92.30%(144/156)和76.28%(119/156),图像质量优+中的比率分别为99.35%(155/156)、91.02%(142/156)和35.25%(55/156)。术后3个月复查有111侧(71.15%)患肢下肢曲张静脉消失,45侧(28.84%)患肢下肢曲张静脉明显减少,143侧(91.67%)患肢大隐静脉主干闭塞,13侧(8.33%)患肢大隐静脉管腔变窄,未见血管复发再通。结论多模态CTV诊断下肢静脉曲张准确率高,能提供全面的病变血管及穿支血管信息,对EVLT联合泡沫硬化杂交手术的术前评估、手术方式的确定以及术后复查具有重要意义。Objective To investigate the value of multimodal CT venography（CTV） in the treatment of lower extremity varicosity by hybrid operation of endovenous laser treatment（EVLT） combining foam sclerosant. Methods Data of 96 patients （156 affected limbs） with primary great saphenous vein varices admitted to Wuxi Third People′s Hospital from Jan.2010 to Apr.2014 were retrospectively analyzed.All of the patients received the hybrid operation of EVLT combining foam sclerosant procedure.Multimodal CTV examination before hybrid operation and 3 months postoperatively was performed to assess the condition of vascular disease. Results All of the 96 patients with 156 affected limbs were diagnosed by multimodal CTV,including 35 cases（22.43%） mild,58 cases（36.71%） moderate and 63 cases（39.87%） severe.Transection and volume rendering images of affected limbs displayed 94.87%（148/156） excellent images and 5.12%（8/156） medium images.The positive rates of perforator venous were 98.71%（154/156）,with 94.23%（147/156） satisfying images to analyze（excellent and medium quality）.The rates of lower leg veins,femoral veins and external iliac veins were 99.35%（155/156）, 92.30 %（144/156） and 76.28% （119/156） respectively.The ratio of image quality excellent ＋ medium was 99.35%（155/156）,91.02%（142/156） and 35.25%（55/156）,respectively.At 3 months postoperatively,varicose vein was undetectable in 111（71.15%） limbs and much decreased in 45（28.84%） l imbs.143（91.67%） limbs had great saphenous vein trunk occlusion and 13（8.33%） limbs had saphenous vein narrowing.No vascular recanalization was found. Conclusion Multimodal CTV can provide accurate and comprehensive details about affected veins and perforator？vessels in the diagnosis of lower extremity varicose veins,therefore,plays an important role in preoperative evaluation,deciding operation procedures and postoperative review of the hybrid operation.

关 键 词：静脉曲张 杂交手术 CT静脉造影 

分 类 号：R445[医药卫生—影像医学与核医学]