Katz Douglas S, Loud Peter A, Hurewitz Adam N, Mueller Richard, Grossman Zachary D
Department of Radiology, Winthrop-University Hospital, 259 First Street, Mineola, NY 11501, USA.
Semin Ultrasound CT MR. 2004 Feb;25(1):67-80. doi: 10.1053/j.sult.2003.10.002.
Pulmonary embolism (PE) and deep venous thrombosis (DVT) are a continuum and are difficult to diagnose clinically. Combined CT venography and pulmonary angiography (CTVPA) is a single examination that combines multidetector CT pulmonary angiography (CTPA) and CT venography (CTV) of the abdomen, pelvis, and lower extremities, providing "one-stop shopping" for venous thromboembolism without additional venipuncture or i.v. contrast, and it adds only a few additional minutes to scanning time. CTVPA rapidly and accurately examines the deep veins, reveals the presence, absence, and extent of deep venous thrombosis, serves as a baseline, and helps guide patient management. Multiple investigators have reported a high degree of accuracy when CTV is compared with venous ultrasound. There are some pitfalls in image interpretation, especially with regard to mixing artifacts, and there are continuing controversies as to exactly which parts of the abdomen, pelvis, and legs should be scanned routinely, the ideal timing of CTV acquisition relative to contrast injection, and the slice thickness and gap, if any, that should be used.
肺栓塞（PE）和深静脉血栓形成（DVT）是一个连续过程，临床诊断困难。联合CT静脉造影和肺血管造影（CTVPA）是一种单一检查，它结合了多排螺旋CT肺血管造影（CTPA）以及腹部、骨盆和下肢的CT静脉造影（CTV），无需额外静脉穿刺或静脉注射造影剂即可为静脉血栓栓塞提供“一站式”检查，且仅增加几分钟扫描时间。CTVPA能快速、准确地检查深静脉，揭示深静脉血栓形成的存在、不存在及范围，作为基线，并有助于指导患者管理。与静脉超声相比，多项研究报告显示CTV具有高度准确性。图像解读存在一些陷阱，尤其是关于混合伪影方面，对于腹部、骨盆和腿部究竟哪些部位应常规扫描、相对于造影剂注射CTV采集的理想时机以及切片厚度和间距（如有）等问题仍存在持续争议。
