von Romatowski H J, Erkelenz I, Kramer R
Rontgenblatter. 1982 Apr;35(4):125-8.
The article describes the technical and anatomical limitations of information supplied by phlebography. Injection of contrast medium into the v. mediana hallucis enables optimal contrast medium distribution. The more proximal the site of injection, the greater the uncertainty of achieving continuous filling of the deep veins with contrast medium. Obstructions during compression (ulcer, oedema) may prove an obstacle to the assessment of insufficient v. perforantes due to overfilling of superficial veins with contrast medium. Even without any abnormal finding it is not possible to stain muscle veins and the v. femoris profunda in about 50% of the examinations. Muscular traction can result in deformation of mainly the v. poplitea and hence results in discontinuous filling with contrast medium if the musculature is not properly relaxed. The veins of the thigh and pelvis must be stained with high contrast in a continuous manner, since otherwise occlusions and collaterals are overlooked in an otherwise normal distal phlebogram. Valve motility can be assessed without additional examination measures directly after ascending phlebography during recumbency of the patient.
本文描述了静脉造影所提供信息的技术和解剖学局限性。将造影剂注入拇趾内侧静脉可实现造影剂的最佳分布。注射部位越靠近近端,造影剂持续充盈深静脉的不确定性就越大。压迫过程中的障碍(溃疡、水肿)可能会因浅静脉造影剂过度充盈而成为评估穿通静脉功能不全的障碍。即使没有任何异常发现,在约50%的检查中也无法使肌肉静脉和股深静脉显影。肌肉牵引主要会导致腘静脉变形,因此如果肌肉组织没有适当放松,会导致造影剂充盈不连续。大腿和骨盆的静脉必须以高对比度连续显影,否则在其他正常的远端静脉造影中会忽略闭塞和侧支循环。在患者仰卧位进行上行静脉造影后,无需额外的检查措施即可直接评估瓣膜活动。