Liu Peng, Peng Junlu, Zheng Lihua, Lu Haili, Yu Weifang, Jiang Xia, Zhang Lei, Song Haixia, Zhao Zengren
Department of General Surgery, The First Hospital of Hebei Medical University Department of Neurology, The First Hospital of Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2018 Aug;97(34):e12002. doi: 10.1097/MD.0000000000012002.
The objectives are to evaluate the application of computed tomography venography (CTV) in the diagnosis of iliac vein compression syndrome (IVCS), and to assess the factors related to the incidence and development of IVCS and the recurrence of varicose veins.Imaging data of 120 patients with chronic venous disease (CVD) of the lower extremity and 68 subjects without CVD (control) were retrospectively reviewed by radiologists blinded to the groups. CTV, conventional venography, and Doppler ultrasound were compared in the diagnosis and contributing factors for IVCS were also analyzed.CTV required less procedure time than venography or color ultrasonography (P < .001). The rate of iliac venous compression diagnosed by CTV was higher in the CVD group (53.3%) than in the control group (22.1%) (χ = 17.425, P < .001). Risk factors for IVCS included gender, hyperlipidemia, and course of disease (P < .05). Development of femoral vein collateral was more common in patients with IVCS (P < .05). The duration of disease was positively associated with the severity of iliac vein compression (r = 0.321, P < .001). IVCS was an important contributing factor for varicose vein recurrence (51.2%). In patients with IVCS and venous ulcer (C5-C6), the healing time of the ulcer treated with stent was significantly shorter compared with those without stent treatment (P < .001).CTV is accurate for the diagnosis and severity evaluation of IVCS. IVCS might be a contributing factor for varicose vein recurrence. Iliac vein stent implantation as a safe and effective interventional therapy promotes the healing of venous ulcer caused by IVCS.
目的是评估计算机断层扫描静脉造影（CTV）在髂静脉受压综合征（IVCS）诊断中的应用，并评估与IVCS的发生、发展以及静脉曲张复发相关的因素。对120例下肢慢性静脉疾病（CVD）患者和68例无CVD的受试者（对照组）的影像数据进行回顾性分析，分析人员对分组情况不知情。比较了CTV、传统静脉造影和多普勒超声在IVCS诊断中的应用，并分析了其相关因素。CTV所需的检查时间比静脉造影或彩色超声检查少（P<0.001）。CVD组通过CTV诊断出的髂静脉受压率（53.3%）高于对照组（22.1%）（χ=17.425，P<0.001）。IVCS的危险因素包括性别、高脂血症和病程（P<0.05）。IVCS患者中股静脉侧支形成更为常见（P<0.05）。病程与髂静脉受压的严重程度呈正相关（r=0.321，P<0.001）。IVCS是静脉曲张复发的一个重要因素（51.2%）。在IVCS和静脉溃疡（C5-C6）患者中，支架治疗的溃疡愈合时间明显短于未进行支架治疗的患者（P<0.001）。CTV对IVCS的诊断和严重程度评估准确。IVCS可能是静脉曲张复发的一个因素。髂静脉支架植入作为一种安全有效的介入治疗方法，可促进由IVCS引起的静脉溃疡的愈合。
