CTV成像在下肢静脉曲张患者解剖特点中的应用研究  

Application of CTV in Anatomical Characteristics of Patients with Lower Extremity Varicose Veins

作　　者：包东明 吴文泽[2] BAO Dong-ming;WU Wen-ze(Yangtze University,Jingzhou 434020,Hubei Province,China;Department of Interventional Radiology,Jingzhou Hospital Affiliated to Yangtze University,Jingzhou 434020,Hubei Province,China)

机构地区：[1]长江大学 [2]长江大学附属荆州医院介入放射科,湖北荆州434020

出　　处：《中国CT和MRI杂志》2025年第4期195-198,共4页Chinese Journal of CT and MRI

基　　金：北京医学奖励基金会课题立项通知书(YXJL-2024-0350-0188)。

摘　　要：目的探讨CT静脉成像(CTV)对下肢静脉曲张(VV)患者下肢静脉解剖特点的术前评估价值。方法回顾性分析了2022年3月-2024年3月本院门诊诊断为疑似VV患者共83例,均于术前完善CTV检查,同时收集术中患者下肢静脉血管造影(DSA)检查结果或手术确诊疾病,以此为“金标准”,评估术前CTV对下肢静脉曲张的诊断价值,对比分析下肢静脉CTV不同静脉显示情况。结果83例患者中有78例被确诊为VV。与“金标准”比较,CTV诊断VV的灵敏度为98.72%,特异度为80.00%,准确率为97.59%,kappa值为0.787(t=7.172,P<0.05),其中对交通静脉瓣膜不全、继发性静脉瓣膜不全、深静脉瓣膜不全、先天性静脉异常和深静脉血栓诊断kappa值分别为0.970、1.000、1.000、1.000、1.000。CTV对股静脉、小腿静脉、髂静脉显影优质率分别为84.62%、97.44%和64.10%。CTV显示浅静脉曲张程度与“金标准”比较,kappa值为0.961(t=11.977,P<0.005)。CTV显示穿支静脉在股骨下段水平组64.10%,腘穿静脉组74.36%,小腿内侧组97.44%,小腿外侧组75.64%。结论术前CTV对VV具有较好的诊断效能,且对VV患者下肢静脉系统显影质量较高。Objective To explore preoperative evaluation value of CT venography(CTV)for anatomical characteristics of lower limb vein in patients with varicose veins(VV).Methods A total of 83 patients with suspected VV in outpatient department of the hospital were retrospectively analyzed between March 2022 and March 2024,all underwent CTV before surgery.The results of digital subtraction angiography(DSA)or surgically confirmed diseases were collected as the golden standard,diagnostic value of preoperative CTV for VV was evaluated,and display of different veins by CTV were compared.Results In the 83 patients,there were 78 cases confirmed with VV.Compared with the golden standard,sensitivity,specificity,accuracy and kappa value of CTV in the diagnosis of VV were 98.72%,80.00%,97.59%and 0.787,respectively(t=7.172,P<0.05).Kappa values of CTV in the diagnosis of venous insufficiency(perforating vein,secondary vein,deep vein),congenital venous abnormality and deep venous thrombosis were 0.970,1.000,1.000,1.000 and 1.000,respectively.The good display rates of femoral vein,calf vein and iliac vein by CTV were 84.62%,97.44%and 64.10%respectively.Kappa value between CTV and the golden standard for displaying the severity of superficial varicose vein was 0.961(t=11.977,P<0.005).The display rates of perforating vein by CTV in lower femur level group,popliteal perforating vein group,medial shank group and lateral shank group were 64.10%,74.36%,97.44%and 75.64%,respectively.Conclusion Preoperative CTV has good diagnosis efficiency for VV,which has high display quality of lower limb vein system in VV patient.

关 键 词：计算机断层扫描静脉成像 下肢静脉曲张 诊断效能 解剖特点 CTV 

分 类 号：R445[医药卫生—影像医学与核医学]