Value of direct dual-source CT venography in diagnosing lower-limb venous ulcer

Abstract:

Objective：To assess the diagnostic value of direct dual-source computed tomography venography（DSCTV） in lower-limb venous ulcers. Methods：Clinical data of patients with suspected lower-limb venous ulcers were collected. With DSCTV，the recon－structed image quality and sites of varicose veins were evaluated；sources of varicose were analyzed，and detection of incompetent veins by DSCTV and duplex ultrasound（DUS） were compared；relations between ulceration and local varicosity were assessed and compared with clinical evaluation. Results：The overall image quality of all 47 affected legs was good. Using DSCTV，99 varicose veins were detected，5 limbs were diagnosed as deep vein thrombosis ，and the rest 42 limbs were considered as chronic venous insufficiency，having no difference compared with DUS in detecting incompetent deep veins and great saphenous veins（P values were 0.70 and 0.51；Kappa values were 0.69 and 0.53）. However，the detection rate of incompetent perforator veins was statistically higher in DSCTV than in DUS（P<0.005）. There was no statistically significant difference between DSCTV and clinical evaluation regarding to relation between ulceration and local varicosity（P=0.41）. Conclusions：DSCTV can provide information about sites and sources of varicose veins，together with referential structures（skin，muscles or bones），thus could guide diagnosis and treatment in patients with lower-limb venous ulcers.