Sato Katsutoshi, Orihashi Kazumasa, Takahashi Shinya, Takasaki Taiichi, Kurosaki Tatsuya, Imai Katsuhiko, Ishifuro Minoru, Sueda Taijiro
Department of Surgery, Division of Clinical Medical Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.
Ann Vasc Dis. 2011;4(3):229-34. doi: 10.3400/avd.oa.11.00021. Epub 2011 Jul 29.
We preoperatively assessed varicose veins by means of computed tomography (CT) with contrast injection in the veins of the lower extremity (CT venography). This paper reports the procedures, results and implications of CT venography from the surgical aspect.
A total of 48 legs in 39 patients were examined. Contrast medium was diluted ten-fold and injected into the lower extremity veins, often using a dual route of injection. The images were reconstructed with the volume-rendering method.
CT venography clearly visualized the veins with a small amount of contrast medium and facilitated the identification of anatomy that was not suitable for passing the stripper. In addition, CT venography helped identify unusual types of varicose veins or uncommon sites of inflow of small saphenous veins. Such information was helpful for avoiding unexpected vascular injury or for minimizing skin incision. Dual-route injection was beneficial to minimize the blind zones. Doppler ultrasound could be more focused on hemodynamic assessment and determination of incision sites.
CT Venography is feasible in all cases of varicose veins. When performed in conjunction with ultrasonography, it appears to facilitate the safe and efficient treatment of various types of varicose veins.
我们通过在下肢静脉注射造影剂的计算机断层扫描（CT）（CT静脉造影）对静脉曲张进行术前评估。本文从手术角度报告CT静脉造影的操作过程、结果及意义。
对39例患者的48条腿进行了检查。造影剂稀释10倍后注入下肢静脉，通常采用双路注射。采用容积再现法重建图像。
CT静脉造影用少量造影剂就能清晰显示静脉，并有助于识别不适合通过剥脱器的解剖结构。此外，CT静脉造影有助于识别不寻常类型的静脉曲张或小隐静脉不常见的流入部位。这些信息有助于避免意外的血管损伤或尽量减少皮肤切口。双路注射有利于减少盲区。多普勒超声可以更专注于血流动力学评估和切口部位的确定。
CT静脉造影在所有静脉曲张病例中都是可行的。与超声检查联合使用时，它似乎有助于安全、有效地治疗各种类型的静脉曲张。
