Shi Wan-Yin, Gu Jian-Ping, Liu Chang-Jian, Lou Wen-Sheng, He Xu
Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, China.
Department of Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, Nanjing, 210006, China.
Int J Cardiovasc Imaging. 2017 Sep;33(9):1277-1285. doi: 10.1007/s10554-017-1112-4. Epub 2017 Mar 13.
Typical iliac vein compression syndrome (IVCS) is characterized by compression of left common iliac vein (LCIV) by the overlying right common iliac artery (RCIA). We described an underestimated type of IVCS with dual compression by right and left common iliac arteries (LCIA) simultaneously. Thirty-one patients with IVCS were retrospectively included. All patients received trans-catheter venography and computed tomography (CT) examinations for diagnosing and evaluating IVCS. Late venography and reconstructed CT were used for evaluating the anatomical relationship among LCIV, RCIA and LCIA. Imaging manifestations as well as demographic data were collected and evaluated by two experienced radiologists. Sole and dual compression were found in 32.3% (n = 10) and 67.7% (n = 21) of 31 patients respectively. No statistical differences existed between them in terms of age, gender, LCIV diameter at the maximum compression point, pressure gradient across stenosis, and the percentage of compression level. On CT and venography, sole compression was commonly presented with a longitudinal compression at the orifice of LCIV while dual compression was usually presented as two types: one had a lengthy stenosis along the upper side of LCIV and the other was manifested by a longitudinal compression near to the orifice of external iliac vein. The presence of dual compression seemed significantly correlated with the tortuous LCIA (p = 0.006). Left common iliac vein can be presented by dual compression. This type of compression has typical manifestations on late venography and CT.
典型的髂静脉压迫综合征（IVCS）的特征是左髂总静脉（LCIV）被上方的右髂总动脉（RCIA）压迫。我们描述了一种未被充分认识的IVCS类型，即同时被右、左髂总动脉（LCIA）双重压迫。回顾性纳入31例IVCS患者。所有患者均接受经导管静脉造影和计算机断层扫描（CT）检查以诊断和评估IVCS。晚期静脉造影和重建CT用于评估LCIV、RCIA和LCIA之间的解剖关系。由两位经验丰富的放射科医生收集并评估影像表现以及人口统计学数据。31例患者中分别发现单纯压迫和双重压迫的比例为32.3%（n = 10）和67.7%（n = 21）。在年龄、性别、最大压迫点处的LCIV直径、狭窄处的压力梯度以及压迫程度百分比方面，两者之间不存在统计学差异。在CT和静脉造影上，单纯压迫通常表现为LCIV开口处的纵向压迫，而双重压迫通常表现为两种类型：一种是沿LCIV上侧有较长的狭窄，另一种表现为在髂外静脉开口附近的纵向压迫。双重压迫的存在似乎与LCIA迂曲显著相关（p = 0.006）。左髂总静脉可出现双重压迫。这种压迫类型在晚期静脉造影和CT上有典型表现。
