Application Study Of Multi-slice CT Angiography For Evaluation Of Venous Occlusive Diseases Of Lower Extremity

Objective To study the image anatomy of the confluens of the common iliac veinusing multi-slice CT angiography and to discuss the relation between the anatomy ofthe confluens of the common iliac vein with the iliac vein compress syndrome. Toassess the value of multi-slice CT angiography in detecting venous occlusive diseasesof lower extremity.Methods The 80 cases without complains and signs of lower extremity venousocclusive diseases were evaluated with 16-slice heical CT angiography.MultiplanarReformation was performed to show the confluens of the common iliac vein. Theconfluens of the common iliac vein were measured as follow.(1) The anteroposteriordiameter of the left common iliac vein in the sagittal plane where the right commoniliac artery crossed.(2) The angle between the common iliac vein and inferior venacave bilaterally.(3) The inner diameter and area of bilateral common iliac vein in thetransection and cross-section. The data were examined using t test.19 suspectedpatients with venous occlusive diseases of lower extremity underwent 16-slice heicalCT angiography and 3D reconstruction.The CT angiography signs of venous occlusivediseases of lower extremity were analyzed and compared with DSA.Results The mean inner diameter and area and their relative value of bilateralcommon iliac vein in the transection exceeded that in the cross-section (t=3.525～7.979, P＜0.01). The mean inner diameter relative value to inferior vena cave exceeded the area relative value to inferior vena cave of bilateral common iliac vein in thecross-section (right side t=13.030, P＜0.001, left side t=10.942, P＜0.001). The anglebetween the right common iliac vein and inferior vena cave was less than that betweenthe left common iliac vein and inferior vena cave (t=-5.893～-8.768, P＜0.001).Theanteroposterior diameter in the sagittal plane and the area in the cross-section of theleft common iliac vein where the right common iliac artery crossed in male groupunder 65-year-old exceeded that in female group (tA1=3.120, tD4=2.880, P＜0.05).The area and its relative value in the cross-section of the left common iliac vein wherethe right common iliac artery crossed in male group over 65-year-old exceeded that infemale group (tD4=2.811, tDr4=2.245, P＜0.05). There was no significant diferenceof the data of the left common iliac vein between the older age-group and non-olderage-group.19 cases of lower extremity venous occlusive diseases were diagnosed byMSCT venography.There were 12 cases of iliac vein compression syndrome,6 cases ofdeep vein thrombosis.No abnormality was seen in 1 cases.18 cases underwentDSA.The results were accordant between DSA and MSCT venography in 17 cases.Conclusion The confluens of the common iliac vein could be evaluated andmeasured in multiplane using multi-slice heical CT angiography,which hasappilication value to the diagnosis of venous occlusive diseases of lower extremity.