三维CT静脉造影对静脉曲张患者下肢静脉系统解剖特点的评估价值  

Value of three-dimensional CT venography in assessing the anatomical features of lower extremity venous system in patients with varicose veins

作　　者：曾蕾 袁江 熊亮 陈思 ZENG Lei;YUAN Jiang;XIONG Liang;CHEN Si(Department of Radiology,Shiyan People's Hospital,Shiyan,Hubei Province 4420o0,China;Department of Neurology,Taihe Hospital,Shiyan,Hubei Province 442000,China)

机构地区：[1]十堰市人民医院放射科,湖北十堰442000 [2]十堰市太和医院神经内科,湖北十堰442000

出　　处：《实用放射学杂志》2022年第9期1443-1446,共4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特点的评估价值.方法 回顾性分析105例疑似的下肢静脉曲张患者的临床资料,获取下肢静脉三维CT静脉造影、手术病理结果和(或)数字减影血管造影(DSA)图像,评估三维CT静脉造影在下肢静脉曲张患者解剖特点中的评价作用.结果 三维CT静脉造影诊断下肢静脉曲张的敏感性为98.98%(97/98),特异性为71.43%(5/7),准确率为98.10%(103/105).三维CT静脉造影对交通静脉瓣膜不全、深静脉瓣膜功能不全、深静脉血栓的检出率分别为 96.77%(30/31)、100.0%(16/16)、92.31%(12/13),与手术诊断结果比较,一致性强(k=0.875,k=1.000,k=1.000).三维CT静脉造影对股静脉优+中显示率为86.03%,对小腿静脉优+中显示率为94.12%,对髂外静脉优+中显示率为66.91%.三维CT静脉造影确定浅静脉曲张轻度26例、中度35例、重度37例,与临床诊断轻度27例、中度34例、重度36例,一致性强(k=0.754).三维CT静脉造影对136侧患肢的穿支静脉的显示率为98.53%(135/136),股骨下端水平组、胭穿静脉组、小腿内侧组、小腿外侧组显示率分别为 63.97%(87/136)、75.00%(102/136)、97.79%(133/136)、75.74%(103/136).结论 CT 静脉造影联合三维图用于下肢静脉曲张诊断具有较高的准确率,可较准确地显示深静脉、浅静脉和穿支静脉,全面显示各条分支静脉的病变特点,针对其解剖结构可判断瓣膜功能不全、静脉血栓等疾病.Objective To evaluate the anatomical features of lower extremity venous system in patients with varicose veins by three-dimensional CT venography.Methods The clinical data of 105 patients with suspected lower extremity varicose veins were analyzed retrospectively.The lower extremity vein three-dimensional CT angiography,surgical pathologic results and(or)digital subtraction angiography(DSA)images were obtained,and the evaluation function of three-dimensional CT venography in patients with lower extremity varicose veins anatomical features were assessed.Results The sensitivity,specificity and accuracy were 98.98%(97/98),71.43%(5/7)and 98.10%(103/105)for three-dimensional CT venography in the diagnosis of lower extremity varicose veins.The detection rates of three-dimensional CT venography for traffic vein valve insufficiency,deep vein valve insufficiency and deep vein thrombosis were 96.77%(30/31),100.0%(16/16)and 92.31%(12/13),respectively.Strongly consistency with surgical diagnosis(k=0.875,k=1.000,k=1.000).The excellent and medium display rate of three-dimensional CT venography in femoral vein was 86.03%,94.12%in calf vein,and 66.91%in external iliac vein.Three-dimensional CT venography confirmed mild varicose vein in 26 cases,moderate varicose vein in 35 cases and severe varicose vein in 37 cases,was strongly consistant with the clinical confirmed mild varicose vein in 27 cases,moderate varicose vein in 34 cases and severe varicose vein in 36 cases(k=0.754).The display rate of the perforator vein of 136 affected limbs by three-dimensional CT venography was 98.53%(135/136).At the level of the lower femur group,the popliteal vein group,the group on the medial leg and the group on the lateral leg were 63.97%(87/136),75.00%(102/136),97.79%(133/136),75.74%(103/136),respec-tively.ConclusionCT venography combined with three-dimensional images has a high accuracy in the diagnosis of lower extremity varicose veins,which can accurately display deep veins,superficial veins and perforator veins,comprehensively display the

关 键 词：三维图像 CT静脉造影 下肢 静脉曲张 解剖特点 

分 类 号：R814.43[医药卫生—影像医学与核医学] R543.6[医药卫生—放射医学] R681.8[医药卫生—临床医学]