| Objiective: Iliac vein compression syndrome(IVCS)is a common venous malady and the incidence of IVCS is likely to escalate in the future,While there is still no definite correlation between the stenosis degree of IVCS and the clinical classification of chronic venous insuffciency(CVI).In order to explore the relationship better and promote clinical treatment,we compare two different methods to evaluate the stenosis degree of iliac vein.Methods: Patients scheduled for varicose vein surgery were invited to attend in the study between September 2016 and August 2017.Two hundred and seventy-five patients with signs and symptoms of CVI were enrolled in the study.This is a retrospective case study conducted and informed consent is waived.The clinical manifestations of these patients were categorized according to the CEAP classification.The stenosis degree of these patients were categorized four classification.In our institute,all patients were routinely evaluated by CT venography CT scans were performed on an 16-row multidetector CT scanner.And the scanning parameters were slightly adjusted to each scanner and patient.All of the CT images were read independently by two radiologists.They assessed the morphology of the left common iliac vein and calculate the stenosis degree of iliac vein by CT area software and CT measuring tool.The data were analyzed with the SPSS version 17.0 software program.The receiver operating characteristic(ROC)curve analysis and pearson correlation coefficient were used in the statistical analysis.Values of p < 0.05 were considered statistically significant.Results: we identified 81 patients who were diagnosed IVCS on pre-proceduralCT venography.By using the “area” method for the calculation of percentage compression,mean percentage compression was(20±34)%,especially male(mean,(21±34)%),femal(mean,(24±31)%.Although women have greater mean compression of the left common iliac vein,there is no statistics significance between them.There is no significant correlation between stenosis degree of nonthrombotic iliac vein compression and clinical classification(P>0.05,AUROC=0.529)or collateral circulation(P>0.05,AUROC=0.529).No statistical significance was found among age,gender(P>0.05).By using the “short diameter” method for the calculation of percentage compression,mean percentage compression was(54±18)%,especially male(mean,(54±18)%),femal(mean,(57±18)%).Although women have greater mean compression of the left common iliac vein,there is no statistics significance between them.There is significant correlation between stenosis degree of nonthrorntmtic iliac vein compression and collateral circulation(P<0.05,AUROC=0.657).No statistical significance was found among age,gender clinical classification(P>0.05).There is no significant correlation between the severity of CVI and gender(P>0.05,AUROC=0.562),age(P>0.05,AUROC=0.458)or collateral circulation(P>0.05,AUROC=0.514).No statistical significance was found among collateral circulationage,gender,age(P>0.05).Conclusion:IVCS are difficult to identify and and there is no significant correlation between stenosis degree of nonthrombotic iliac vein compression and clinical classification.The iliac vein compress can result in the change of hemodynamics on the system of lower limb vein corresponding clinical symptoms.It's diagnose depend on a variety of imaging methods.Compare to other imaging methods,CT area software is more accurate than “short diameter” method to evaluate the stenosis degree of IVCS.In conclusion,it appears to be a feasible way to evaluate the change of hemodynamics by CT area software,and the method can reflect the clinical symptoms better and boost the treatment.Although there is no standard care of NIVCS,the goal is to reduce the change of hemodynamics.The formation of collaterals may be regarded as acompensatory mechanism to bypass and alleviate the obstruction.We should make feasible treatments according to different factors especially when facing large collateral existing among IVCS. |
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