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논문 기본 정보

자료유형
학술저널
저자정보
정진욱 (서울대학교 의과대학 진단방사선과학교실, 방사선의학연구소)
저널정보
대한영상의학회 대한방사선의학회지 대한방사선의학회지 제39권 제5호
발행연도
1998.1
수록면
907 - 913 (7page)

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Purpose : To determine the clinical usefulness of spiral computed tomographic (CT) venography for the evaluation of central venous obstruction. Materials and Methods : The authors prospectively performed a total of29 spiral CT venography procedures in 25 consecutive patients with suspected central venous obstruction. Diluted contrast media were directly injected into the peripheral veins of the hand or the foot. Scan parameters were 3mmX-ray beam collimation, table speed of 4-6 cm/sec, scan time of 32-40 sec, and injection delay of 20 sec. Axial images were reconstructed at 2-mm intervals, and using shaded surface display (SSD), maximum intensity projection(MIP), and multiplanar reformation (MPR), 3-D reconstruction was performed. In all cases, ascending venograp-hy(n=13) and/or direct catheter venography (n=21) was performed within 2 days of CT venography. With regard to site, extent, extent, severity, and cause of obstruction and collateral circulation, we compared the results of CT and contrast venography. Results : In 24 patients, a total of 56 sites of central venous obstruction or stenosis (>50%) were demonstrated. The causes of obstruction were venous thrombosis(n=6), malignant tumors (n=4),arteriovenous fistula for hemodialysis(n=5), extrinsic compression(n=2), coincidence of extrinsic compression and arteriovenous fistula (n=1), pacemaker (n=1), mediastinal inflammatory pseudotumor (n=1), spinal tuberculosis(n=1), membranous obstruction of the hepatic inferior vena cava (n=1), Behcet's disease (n=1), or unknown cause(n=1). When compared with ascending venography (n=13), CT venography was superior for evaluation of the extent and cause of obstruction and collateral circulation in two, four and one case(s), respectively. For the evaluation of site and severity of obstruction, CT venography was equal to ascending venography. In two cases, direct catheter venography (n=21) was superior to CT venography for evaluating the obstruction site, but in three, five and one case(s) respectively, CT venography was superior to direct catheter venograp-hy for evaluating the extent and cause of obstruction and collateral circulation. For the evaluation of severity of obstruction, CT and direct catheter venography were equal. Conclusion : In patients with suspected central venous obstruction, spiral CT venography can be an alternative to replace not only conventional CT but also direct contrast venography.

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