| Objective: To assess the value of multi-slice spiral CT(MSCT) in differentiating acute and chronic deep venous thrombosis(DVT), and to investigate the correlation of MSCT presentation of DVT to PT, APTT, FIB and TT.Materials and Methods: The MSCT data of 37 DVT patients diagnosed by digital subtraction angiography(DSA) were retrospectively studied. Firstly, these cases were grouped by course of disease. The acute DVT were those course within two weeks, and the chronic DVT were beyond two weeks, and those who with a long DVT history but had an onset within two weeks were grouped into acute DVT. The appearance of thrombus,vessels and soft tissue were reviewed in enhanced MSCT. The CT value and standard deviation of thrombus were measured in non-enhanced MSCT. The CT value and standard deviation were examined by independent-samples t test, and p<0.05 showed the differences have statistical significance. Then, these cases were grouped again according to the form, distribution and CT value of thrombus in MSCT. The differences of PT, APTT, FIB and TT between groups were examined by independent-samples t test, and p<0.05 showed the differences have statistical significance.Results:①According to the course of disease, 18 cases were acute DVT including 3 cases which had a DVT history beyond 2 weeks but had an onset within 2 weeks, and 19 cases were chronic DVT. The acute DVT showed central type filling defect in dilated veins, usually successive distributed. The soft tissue were swelling significantly. The acute DVT presented as "target sign" and "double-track sign" in axial section and reconstructed section respectively. The chronic DVT showed decentral type filling defect, usually segmental distributed. Lateral branches and superior veins got more and circuitous. The CT value of acute and chronic DVT were 59.26±11.89HU and 37.42±9.46HU (u=20.92, p<0.05). The difference had statistical significance. The standard deviation of acute and chronic DVT were 12.46±3.43 and 8.34±2.96 (t=4.27, p<0.05). The difference had statistical significance.②In enhanced MSCT, these cases were divided into central type filling defect and decentral type filling defect according to the thrombus form, and they were 23 and 14 cases respectively. According to the thrombus distribution, they were divided into successive distribution and segmental distribution, and they were 19 and 18 cases respectively. If one had both two presentation, then it was grouped into the major one. The crossing point of acute and chronic DVT CT value was 53.6HU calculated by WPS office excel software. 24 cases were higher than 53.6HU and 13 cases were lower than it. Compared group central type filling defect and decentral type filling defect, PT, APTT and FIB of the former were higher. All had statistical differences (t=4.95, 3.27, 4.05, p<0.05). TT had no statistical differences between the two groups(t=0.53, p>0.05). Compared group successive distribution and segmental distribution, PT of the former one was higher and had statistical difference(t=6.10, p<0.05). APTT, FIB and TT had no statistical differences(t=1.88, 1.46, 1.95, p>0.05). Compared group CT value≥53.6HU and CT value <53.6HU, PT, APTT and FIB of the former were higher. All had statistical differences(t=3.97, 6.21, 6.14, p<0.05). TT had no statistical differences between the two groups(t=1.99, p>0.05).Conclusion: In the 37 DVT cases, the MSCT presentation of acute and chronic DVT had crossing section, but they had the major presentation respectively, and he CT value and standard deviation of thrombus could infer the acute or chronic one, and MSCT presentation had some correlation to PT, APTT and FIB except TT. Combine MSCT with coagulation and fibrosis examination could improve the accuracy of the diagnose of acute and chronic DVT, then guide the treatment more reliably.
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