Uhl J F, Verdeille S, Martin-Bouyer Y
Varicose Vein Surgical Center, Neuilly, France.
Vasa. 2003 May;32(2):91-4. doi: 10.1024/0301-1526.32.2.91.
The purpose of pre-operative spiral CT venography or veno-CT (VCT) is to provide a precise 3D anatomic depiction of the venous network, to be used as a guideline by the surgeon.
A multislice and multidetector spiral CT acquisition of the lower limb with diluted contrast injection produces about 400 slices in 30 s. Dedicated volume-rendering software compute interactive 3D images of the venous system. Dynamic data are easily exported by e-mail and available for phlebologists and surgeons. As VCT provides no hemodynamic data, an associated color-coded duplex is mandatory.
VCT is useful in case of post-operative recurrence (especially of the popliteal fossa), high or dystrophic termination of the short saphenous vein, varices feeded by the Giacomini vein, and to investigate pelvic or pudental varicose veins. A full knowledge of the complex venous networks is possible thanks to interactivity of the resulting 3D model, using rotation and modification of transparency of the tissues.
Providing a more complete anatomical information, VCT makes possible a better surgical choice of technique, avoiding anatomic pitfalls, with a more precise and limited skin approach. Accordingly, it may hopefully improve the aesthetic result as well as the efficacy, by reducing the varicose veins recurrence rate.
术前螺旋CT静脉造影或静脉CT（VCT）的目的是提供静脉网络精确的三维解剖图像，供外科医生用作指导。
通过注射稀释造影剂对下肢进行多层多探测器螺旋CT扫描，30秒内可产生约400层图像。专用的容积再现软件可计算静脉系统的交互式三维图像。动态数据可通过电子邮件轻松导出，供静脉病学家和外科医生使用。由于VCT不提供血流动力学数据，因此必须同时进行彩色编码双功超声检查。
VCT在术后复发（尤其是腘窝复发）、小隐静脉高位或营养不良性终止、由 Giacomini 静脉供血的静脉曲张以及研究盆腔或阴部静脉曲张的情况下很有用。借助所得三维模型的交互性，通过旋转和改变组织透明度，可以全面了解复杂的静脉网络。
VCT提供了更完整的解剖信息，使外科手术技术选择更优，避免解剖陷阱，采用更精确且有限的皮肤切口。因此，有望通过降低静脉曲张复发率来改善美观效果和治疗效果。
