三维CT静脉造影对下肢静脉曲张的应用价值  

Application of three-dimensional CT venography in varicose veins of lower limb

作　　者：姜旭栋 周益 成岗 JIANG Xudong;ZHOU Yi;CHENG Gang(Department of Imaging,the Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu Province 214000,China)

机构地区：[1]江南大学附属医院影像科,江苏无锡214000

出　　处：《实用放射学杂志》2020年第7期1059-1063,共5页Journal of Practical Radiology

摘　　要：目的 探讨三维CT静脉造影对静脉曲张患者下肢静脉系统解剖变化的应用价值.方法 回顾性分析确诊并治疗的80例下肢静脉曲张患者的临床资料,其中36例(45侧肢体)为静脉顺行造影作为对照组、44例(56侧肢体)为三维CT静脉造影检查作为研究组.分别于治疗前、后获得2组血管图像和下肢静脉系统解剖变化;ROC曲线分析三维CT静脉造影对静脉曲张的诊断价值.结果 2组SNR、CNR、图像质量评分、对比增强率有显著差异(P<0.05);Kappa检验中,研究组与临床确诊在交通静脉瓣膜不全、先天性静脉发育异常、继发性静脉瓣膜功能不全、深静脉瓣膜功能不全、深静脉血栓的诊断上一致性较强(k=0.359,k=0.372,k=0.481,k=0.415,k=0.541);研究组静脉内径、曲张返流程度、返流速度均高于对照组(P<0.05);研究组影响图像质量评分总不良因素低于对照组(P<0.05);研究组、对照组评价下肢静脉曲张AUC分别为0.977、0.421(P=0.015),三维CT静脉造影检查对诊断静脉曲张的敏感性高于常规平扫(P<0.05).结论 基于三维CT静脉造影能直观准确评价静脉曲张患者下肢静脉解剖特点,可定量分析下肢曲张静脉残存或复发情况.Objectire To investigate the anatomical changes of lower limb venous system in patients with waricose veins based on three dimensional CT venography.Methods The clinical data of 80 patients with varicose veins of lower limb Hiagnosed and treated were analyzed retrospectively.36 patients(45 limbs)in the control group underwent anterograde venography,while 44 patients(56 limbs)in the study group underwent three dimensional CT venography.Vascular images and anatomicnl changes of lower limb venous system were olhserved in two groups.ROC curve was used to analyze tbe diagnosis value of three dimensional CT venography in varicose veins.Results The SNR.CNR。image quality eore and contrast enhanement rate of the two groups were satisticallyy dfferet(P<0.05).Kappe test showed thet the study group w8s in good agreement with elinical diagnosis in the dignosis of perforator vein incompetence.congenital venous dysplasia,scodary venrows incomp nence,dep venous incompetenre and deep venouse thrombosis(k=0.359,k=0.372,k=0.481。4-0.415,k=0.541).Venows dimeter dgree and velocity of varicoee reflux in the study growp were all higher than those in the control group(P<0.05).The total adverse factors aletige image quality score in the study group were lower than those in the control goup(P<0.05).The AUC was0,977 in the study group and 0.421 in the corrol group,respectively(P=0.015).The sensitivity of throer dimensional CT vonography in the diagnosis of varicose vins was higher than that of conwentionsl plain san(P<0.05).Conclusion Based on three-dimensionl CT venography。the anatomnical features of the lower exremity weins of patients with varicose veins can be visually and accurately evaluated.It an be used for quantitative analysis of residual or rcurrnce of varicose veins of lower limb.

关 键 词：CT静脉造影 下肢 静脉曲张 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.6[医药卫生—放射医学]