Voigts B, Abolmaali N, Stelzner C, Schellong S M
Medizinische Klinik 2, Städtisches Klinikum Dresden, Campus Friedrichstadt, Friedrichstr. 41, 01067, Dresden, Deutschland.
Klinik für Radiologie, Städtisches Klinikum Dresden, Campus Friedrichstadt, Dresden, Deutschland.
Internist (Berl). 2017 Aug;58(8):796-804. doi: 10.1007/s00108-017-0281-5.
Several techniques are available for imaging of the venous system of the legs and pelvic region. In cases of suspected deep leg vein thrombosis B‑mode compression ultrasound is applied. Its accuracy is sufficient to either confirm or exclude the diagnosis with certainty. For examination of the iliac veins, however, flow information has to be added by pulsed wave (PW) Doppler or color Doppler sonography. In cases of suspected arm vein thrombosis, ultrasound is also the method of choice. The more proximal or the central parts of the venous system, i. e. brachiocephalic veins or the superior and inferior vena cava can be visualized by cross-sectional imaging procedures. Computed tomography (CT) angiography accurately shows the vessel lumen and magnetic resonance imaging (MRI) provides more details of the surrounding soft tissue. The use of classical contrast medium phlebography is nowadays restricted to interventions on proximal or central parts of the venous system. In addition, venous imaging is required in the field of chronic venous insufficiency. For both differential diagnostics and choice of treatment options, e. g. for varicose veins, the mainstay is venous ultrasound.
有几种技术可用于腿部和盆腔区域静脉系统的成像。在怀疑有下肢深静脉血栓形成的情况下，应用B型加压超声检查。其准确性足以确定地证实或排除诊断。然而，对于髂静脉的检查，必须通过脉冲波（PW）多普勒或彩色多普勒超声检查来补充血流信息。在怀疑有上肢静脉血栓形成的情况下，超声也是首选方法。静脉系统的近端或中心部分，即头臂静脉或上、下腔静脉，可以通过断层成像程序进行可视化。计算机断层扫描（CT）血管造影能准确显示血管腔，磁共振成像（MRI）能提供周围软组织的更多细节。如今，传统的造影剂静脉造影仅限于对静脉系统近端或中心部分的干预。此外，在慢性静脉功能不全领域也需要进行静脉成像。对于鉴别诊断和治疗方案的选择，例如对于静脉曲张，主要依靠静脉超声检查。
