AJR 2002; 178:1465-1471
© American Roentgen Ray Society
Pitfalls in CT Venography of Lower Limbs and Abdominal Veins
B. Ghaye1,
D. Szapiro,
V. Willems and
R. F. Dondelinger
1 All authors: Department of Medical Imaging, University Hospital Sart Tilman
B35, B-4000 Liege, Belgium.
Received August 2, 2001;
accepted after revision December 6, 2001.
Address correspondence to B. Ghaye.
Introduction
Deep venous thrombosis (DVT) and pulmonary embolism are described as two
aspects of the same continuum—venopulmonary thromboembolic disease,
which results in significant morbidity and mortality
[1]. Recent studies
[1,2,3,4,5,6]
have found that a combination of helical CT angiography of pulmonary arteries
and indirect CT venography of lower limbs allows a complete one-session
evaluation of venopulmonary thromboembolism. Sensitivities of 89-100% and
specificities of 94-100% have been reported and compared with sonography
[3,
4,
6]. Nevertheless, detection of
an acute clot with CT venography requires optimal selection of technical
parameters, knowledge of venous anatomy and common variants, and knowledge of
CT signs reflecting DVT. The radiologist should also be aware of
interpretative difficulties inherent to the CT examination of limb veins. We
review the practical approach to DVT with CT venography on the basis of our
experience with more than 800 combined examinations.
Technique
We aquired 50-60 5-mm-thick axial CT venograms every 20 mm from the ankle
to the diaphragm after injection of 140 mL of 300 mg I/mL contrast medium at a
flow rate of 3 mL/sec through an antecubital vein for helical CT angiography
of the pulmonary arteries. An optimal and homogeneous venous enhancement and a
sufficient vein-to-muscle attenuation gradient were obtained when scanning was
started 3 min 30 sec after contrast medium injection for helical CT
angiography of pulmonary arteries
[7]. Despite optimal timing,
insufficient venous opacification, particularly at the sural level, can occur
in an unpredictable manner (Figs.
1 and
2) in as many as 15% of
patients.
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Fig. 1. —Heterogeneous venous enhancement associated with early
scanning in 45-year-old man who was suspected of having pulmonary embolism.
Axial CT venogram, acquired less than 2 min 30 sec after contrast medium
injection, shows heterogeneities in left external iliac vein (arrow),
which may simulate deep venous thrombosis (DVT). Scanning was repeated 1 min
later (not shown) and revealed homogeneous enhancement. Sonogram (not shown)
confirmed absence of DVT. Findings of helical CT angiogram (not shown) were
negative for pulmonary embolism.
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Fig. 2. —Contrast sedimentation in dilated vein in 75-year-old woman
who was suspected of having pulmonary embolism. Axial CT venogram reveals
contrast—fluid level in left internal gastrocnemius vein
(arrow) in patient who had no symptoms of deep venous thrombosis.
Such layering occurs in enlarged veins with slow flow. Confirmation of normal
patency can be achieved by rescanning with CT, or with sonography, 60-120 sec
later. Findings were negative for pulmonary embolism (not shown).
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Venous Anatomy
The legs and abdomen usually contain one vein per artery. The caliber of
veins is similar to that of the corresponding artery for the inferior vena
cava, common and external iliac veins, common and superficial femoral veins,
and popliteal vein. The venous caliber is larger compared with the
corresponding artery for the internal iliac vein, deep femoral vein, and veins
below the knee. Venous diameter reflects its capacious role. The superficial
veins such as the greater and lesser saphenous veins are not accompanied by a
corresponding artery. The renal vein, gonadal vein, internal iliac vein,
greater saphenous vein, deep femoral vein, and lesser saphenous vein are
visible on CT venography but are usually poorly opacified or are not opacified
on state-of-the-art ascending venography and are among the most difficult to
study on sonography (Fig.
3A,3B,3C,3D).
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Fig. 3A. —Normal venous anatomy of lower limbs in 45-year-old man who
was suspected of having pulmonary embolism. Axial CT venogram obtained at
thigh level shows normal enhancement of superficial femoral vein (thin
white arrow), deep femoral vein (black arrow), greater saphenous
vein (thick white arrow), and multiple small muscular veins
(arrowheads).
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Fig. 3B. —Normal venous anatomy of lower limbs in 45-year-old man who
was suspected of having pulmonary embolism. Axial CT venogram obtained at
popliteal level shows normal popliteal vein (black arrow) and greater
saphenous vein (white arrow).
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Fig. 3C. —Normal venous anatomy of lower limbs in 45-year-old man who
was suspected of having pulmonary embolism. Axial CT venogram obtained at
upper calf level shows normal caudal part of popliteal vein (black
arrow). Arrowheads point to branches of gastrocnemius veins. White arrow
points to greater saphenous vein.
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Fig. 3D. —Normal venous anatomy of lower limbs in 45-year-old man who
was suspected of having pulmonary embolism. Axial CT venogram obtained at mid
calf level shows posterior tibial veins (medium black arrow),
peroneal veins (long black arrow), and anterior tibial veins
(short black arrow) located adjacent to their corresponding artery.
Note good opacification of sural veins (arrowhead) and lesser
saphenous vein (white arrow).
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Anatomic Variants
Duplication
Although duplication of the deep venous system below the knee is the usual
anatomy, the popliteal vein, superficial femoral vein, and inferior vena cava
may be occasionally duplicated, or a single left-sided inferior vena cava may
be present (Figs. 4 and
5). The incidence of duplicated
venous segments in the lower extremity is high. The superficial femoral vein
is duplicated over at least a short segment in 15-20% of patients, whereas the
popliteal vein is duplicated in up to 35% of patients
[8]. The duplicated segments of
the superficial femoral vein vary in length and join the main venous trunk.
There is a higher prevalence of duplicated femoral segments in patients with
DVT [8]. Duplication of a
popliteal vein tends to continue as separate duplicated segments.
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Fig. 4. —Duplication of superficial femoral veins in 78-year-old woman
who was suspected of having deep venous thrombosis and pulmonary embolism.
Axial CT venogram shows bilateral duplication of superficial femoral veins
(arrowheads). One right vein (arrow) is thrombosed, which is
classical pitfall shown on sonography but easily recognized on CT venography.
Findings of helical CT angiogram (not shown) were negative for pulmonary
embolism.
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Fig. 5. —Thrombosed left-sided inferior vena cava in 25-year-old woman
with confirmed pulmonary embolism who was taking oral contraceptives. Axial CT
venogram revealed deep venous thrombosis in right common femoral vein (not
shown) and in left-sided inferior vena cava (arrow). No right-sided
inferior vena cava was present. Thrombosed left-sided inferior vena cava
should not be confused with necrotic lymph nodes.
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Unusual Venous Pathway
Direct venous continuation of the popliteal vein in the deep femoral vein
occurs in 10-15% of patients and may be associated with a reduced size of the
superficial femoral vein. Continuation of the deep femoral vein in the
internal iliac vein is rarely encountered (Fig.
6A,6B,6C).
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Fig. 6A. —Direct continuation of popliteal vein by deep femoral vein
and internal iliac vein (sciatic vein) in 73-year-old man with proven
pulmonary embolism. Findings of helical CT angiogram (not shown) were positive
for pulmonary embolism. Patient had no clinical sign of deep venous
thrombosis. Axial CT venogram shows right popliteal vein dividing in normal
superficial femoral vein and deep vein with clot (arrow) running
parallel to sciatic nerve (sciatic vein).
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Fig. 6B. —Direct continuation of popliteal vein by deep femoral vein
and internal iliac vein (sciatic vein) in 73-year-old man with proven
pulmonary embolism. Findings of helical CT angiogram (not shown) were positive
for pulmonary embolism. Patient had no clinical sign of deep venous
thrombosis. Axial CT venogram located 5 cm superior to A shows
enlargement of sciatic vein with mural thrombus (arrow). Note
presence of communication between this abnormal vein and deep femoral vein
(arrowhead).
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Fig. 6C. —Direct continuation of popliteal vein by deep femoral vein
and internal iliac vein (sciatic vein) in 73-year-old man with proven
pulmonary embolism. Findings of helical CT angiogram (not shown) were positive
for pulmonary embolism. Patient had no clinical sign of deep venous
thrombosis. Axial CT venogram located 10 cm superior to B shows
abnormal vein continuing toward sciatic notch (arrow) and finally
entering internal iliac vein (not shown). Note presence of clot in left
gluteal vein (arrowhead).
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Congenital Absence
The congenital absence of a vein may be associated with an unusual venous
pathway and may be difficult to differentiate from complete postphlebitic
fibrosis. These venous aspects are more easily revealed on CT venography than
on sonography or on ascending venography.
CT Signs of Deep Venous Thrombosis
Acute Deep Venous Thrombosis
The most reliable CT sign allowing a confident diagnosis of DVT is the
visualization of a clot, presenting as a complete, partial, or juxtamural
filling defect. Other signs of acute DVT include upstream venous dilatation
compared with the normal contralateral side, perivenous soft-tissue
infiltration suggestive of edema, a dense rim due to contrast staining in the
vasa vasorum of the venous wall or contrast accumulation delineating the
intraluminal clot, and opacification of collateral veins
[1,
2]
(Fig. 7).
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Fig. 7. —Acute deep venous thrombosis (DVT) in 62-year-old man who
presented with typical symptoms and signs of pulmonary embolism and DVT. Axial
CT venogram obtained at sural level shows multiple DVT in duplicated
tibioperoneal trunk (black arrow) and sural vein (white
arrow) on left side. Note central filling defects associated with venous
dilatation compared with normal contralateral side. Note also swelling of calf
and presence of multiple superficial collaterals (arrowheads).
Findings of helical CT angiogram (not shown) were positive for pulmonary
embolism.
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Chronic Deep Venous Thrombosis
We have found that direct visualization and delineation of a clot with an
irregular margin, occasionally containing calcifications, are the most
specific vascular finding of chronic DVT on CT venography. Thrombus is often
eccentric, with a large portion adherent to the vein wall. Chronic DVT may
also appear as thick-walled and poorly enhancing veins. Partial clot
recanalization may result in a heterogeneous lumen and strands
(Fig. 8). Multiple deep or
superficial collaterals are commonly encountered. Other signs include small
retracted veins and ultimately a fibrous cord replacing the vein.
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Fig. 8. —Chronic deep venous thrombosis (DVT) in 70-year-old man who
presented with history of multiple episodes of DVT and was suspected of having
pulmonary embolism. Axial CT venogram obtained at popliteal level shows
multiple collateral veins, some dilated and with endoluminal strands or
calcifications (arrows). Perivenous fat was normal. Findings of
helical CT angiogram (not shown) were negative for pulmonary embolism.
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Deep Venous Thrombosis in Unusual Locations
Unlike conventional venography, all veins of the body are opacified after
contrast medium injection in an arm vein. This allows identification of DVT in
veins usually not opacified on venography and not studied on sonography. DVT
located in the internal iliac venous system, deep femoral veins, renal veins,
gonadal veins, and hepatic veins are well visualized on CT venography (Figs.
9,10,11).
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Fig. 9. —Unusual location of deep venous thrombosis in 72-year-old
woman who was suspected of having pulmonary embolism. Axial CT venogram shows
clot in branch of anterior trunk of internal iliac vein (arrow).
Findings of helical CT angiogram (not shown) were negative for pulmonary
embolism.
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Fig. 10. —Unusual location of deep venous thrombosis (DVT) in
64-year-old woman who presented with symptomatic DVT of right leg that was
confirmed on CT venogram (not shown). Axial CT venogram also shows
asymptomatic clot in left renal vein (arrow) and portal vein
(arrowhead). This patient also had clot in right hepatic vein (not
shown). Findings of helical CT angiogram (not shown) were positive for
pulmonary embolism.
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Fig. 11. —Unusual location of deep venous thrombosis (DVT) in
48-year-old woman who was suspected of having pulmonary embolism after pelvic
surgery. Axial CT venogram shows asymptomatic DVT in left ovarian vein
(arrow). Findings of helical CT angiogram (not shown) were positive
for pulmonary embolism.
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Differentiation from Other Normal or Abnormal Structures
DVT can be easily differentiated from other nonvenous normal or abnormal
structures, such as thrombosed native artery; thrombosed arterial bypass; and
lymph node, including necrotic or fat-containing adenopathy, muscular hematoma
or abscess, popliteal cyst, muscular heterogeneities as seen in the
compartment syndrome, normal aponeurosis and tendon, and normal or tumoral
sciatic nerve (Figs.
12,13,14,15,16,17,18,19,20).
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Fig. 12. —Thrombosed artery mimicking deep venous thrombosis in
72-year-old man who was suspected of having pulmonary embolism. Axial CT
venogram shows thrombus located in right external iliac artery. Arrowhead
points to right external iliac vein, black arrow points to thrombosed external
iliac artery, and white arrow points to patent aortofemoral bypass.
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Fig. 13. —Normal lymph node of left groin mimicking deep venous
thrombosis in 69-year-old man who was suspected of having pulmonary embolism.
Axial CT venogram shows normal lymph node (arrow). Lymph nodes can
cause frequent pitfalls on single-slice CT because they may appear with
hypervascular rim and central fatty hypodensity. Sonogram (not shown)
confirmed diagnosis of lymph node with hyperechoic center.
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Fig. 14. —Muscular hematoma mimicking deep venous thrombosis in
56-year-old man treated with anticoagulation who was suspected of having
pulmonary embolism. Axial CT venogram shows muscular hematoma (arrow)
located in left psoas muscle. Arrowhead points to normal common femoral
vein.
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Fig. 15. —Muscular abscess mimicking deep venous thrombosis in
72-year-old man with diabetes mellitus who was suspected of having pulmonary
embolism. Axial CT venogram shows hypodense lesion with enhancing peripheral
rim corresponding to abscess (arrow) located in left iliac muscle.
Arrowhead points to normal external iliac vein.
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Fig. 16. —Popliteal cyst mimicking deep venous thrombosis (DVT) in
65-year-old woman who was suspected of having pulmonary embolism. Axial CT
venogram shows small popliteal cyst (arrow) that should not be
confused with DVT. Small popliteal cysts are frequent findings on CT
venography. They usually produce no diagnostic problems because of their
typical shape and location. Arrowhead points to normal popliteal vein.
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Fig. 17. —Acute compartment syndrome mimicking deep venous thrombosis
(DVT) in 69-year-old woman who was suspected of having pulmonary embolism.
Axial CT venogram obtained at calf level shows multiple and heterogeneous
areas of muscular contrast enhancement because of severe distal arteritis with
acute compartment syndrome. Such finding may mimic filling defects
(arrowheads) and should not be confused with DVT.
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Fig. 18. —Flexor hallucis longus muscle and tendon mimicking deep
venous thrombosis (DVT) in 25-year-old woman who was suspected of having
pulmonary embolism. Axial CT venogram shows frequent pitfall in our experience
with CT venogram obtained at level of lower calf. Arrowheads point to
periphery of flexor hallucis longus muscle, which is hyperattenuating on right
side. Curved aspect of this structure may frequently simulate DVT.
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Fig. 19. —Sciatic nerve mimicking deep venous thrombosis (DVT) in
62-year-old woman who was suspected of having pulmonary embolism. Axial CT
venogram shows usual appearance of sciatic nerve on right side with rimlike
hyperdensity and central hypodensity (long arrow) mimicking deep
venous thrombosis (DVT). Normal right sciatic vein is located along sciatic
nerve (arrowhead). Note also clot in left sciatic vein (short
arrow) that extended into popliteal vein (not shown). Findings of helical
CT angiogram (not shown) were positive for pulmonary embolism.
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Fig. 20. —Neurinoma mimicking deep venous thrombosis in 42-year-old man
who was suspected of having pulmonary embolism. Axial CT venogram shows
neurinoma of left sciatic nerve (arrow). Peripheral neurogenic tumors
classically present with peripheral hypervascular rim and central hypodensity.
Correct diagnosis can be suggested by rounded or oval aspect of tumor on
multiplanar reconstructions. Sonogram (not shown) confirmed diagnosis.
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Pitfalls Related to Beam-Hardening Artifacts
Streak or beam-hardening artifacts resulting in hypodense or hyperdense
streaks in the neighboring structures are commonly encountered and may be
generated by orthopedic material, bone, vascular calcifications, or dense
contrast medium in the urinary bladder. Plaster does not produce artifacts.
Such artifacts can be distinguished from DVT because they extend through the
vessel into the perivascular tissue and are straight in contrast to a clot,
which is rounded and can be seen on consecutive images
[5] (Figs.
21,22,23,24,25).
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Fig. 21. —Beam-hardening artifacts on CT venogram in 52-year-old man
who was suspected of having pulmonary embolism. Axial CT venogram shows clots
(arrows) in left superficial and deep femoral veins despite presence
of streak artifacts from orthopedic material. In our experience, image quality
is not degraded in 76% of patients with extensive orthopedic material.
Findings of helical CT angiogram (not shown) were positive for pulmonary
embolism.
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Fig. 22. —Beam-hardening artifacts on CT venogram in 63-year-old woman
who was suspected of having postoperative pulmonary embolism. Axial CT
venogram of left common femoral vein shows strong beam-hardening artifacts
from left dynamic hip screw preventing interpretation of patency of vein
(arrow). Findings of sonogram were normal, and helical CT angiogram
(not shown) was negative for pulmonary embolism.
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Fig. 23. —Beam-hardening artifacts from bone on CT venogram in
70-year-old man who was suspected of having pulmonary embolism. Axial CT
venogram shows filling defects (arrows) in peroneal veins on both
sides. Multiple streaks around fibula are common findings on CT venography.
Such artifacts can be differentiated from clot as they cross vessels and
continue in surrounding tissue (arrowheads). They may become more
obvious by narrowing window setting to enhance contrast. Sonogram (not shown)
confirmed venous patency, and helical CT angiogram (not shown) was negative
for pulmonary embolism.
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Fig. 24. —Beam-hardening artifacts from vascular calcification in
69-year-old man who was suspected of having pulmonary embolism. Axial CT
venogram of right superficial femoral vein shows apparent sharply demarcated
filling defect (arrow) caused by superficial femoral artery
calcifications. Findings of sonogram (not shown) were normal.
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Fig. 25. —Acute deep venous thrombosis (DVT) in 72-year-old woman with
right pelvipodal plaster cast and history of immobilization for long period
who was suspected of having pulmonary embolism. Axial CT venogram allows
perfect visualization of asymptomatic DVT (arrow). Note thrombus in
right and left superficial femoral arteries (arrowheads). Sonogram
(not shown) was impossible to visualize, and conventional venogram was
difficult to obtain. Findings of helical CT angiogram (not shown) were
positive for pulmonary embolism.
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References
-
Loud PA, Grossman ZD, Klippenstein DL, Ray CE. Combined CT
venography and pulmonary angiography: a new diagnostic technique for suspected
thromboembolic disease. AJR
1998;170:951
-954[Free Full Text]
-
Ghaye B, Szapiro D, Willems V, Dondelinger RF. Combined CT
venography of the lower limbs and spiral CT angiography of pulmonary arteries
in acute pulmonary embolism: preliminary results of a prospective study.
JBR-BTR
2000;83:271
-278
-
Loud PA, Katz DS, Klippenstein DL, Shah RD, Grossman ZD. Combined
CT venography and pulmonary angiography in suspected thromboembolic disease:
diagnostic accuracy for deep venous evaluation. AJR
2000;174:61
-65[Abstract/Free Full Text]
-
Garg K, Kemp JL, Wojcik D, et al. Thromboembolic disease:
comparison of combined CT pulmonary angiography and venography with bilateral
leg sonography in 70 patients. AJR
2000;175:997
-1001[Abstract/Free Full Text]
-
Cham MD, Yankelevitz DF, Shaham D, et al. Deep venous thrombosis:
detection by using indirect CT venography. Radiology
2000;216:744
-751[Abstract/Free Full Text]
-
Duwe DM, Shiau M, Budorick NE, Austin JHM, Berkmen YM. Evaluation
of the lower extremity veins in patients with suspected pulmonary embolism: a
retrospective comparison of helical CT venography and sonography.
AJR
2000;175:1525
-1531[Abstract/Free Full Text]
-
Szapiro D, Ghaye B, Willems V, Zhang L, Albert A, Dondelinger RF.
Evaluation of time-density curves of the veins of the lower limbs.
Invest Radiol
2001;36:164
-169[Medline]
-
Polak JF. Venous thrombosis. In: Polak JF, ed.
Peripheral vascular sonography. Baltimore: Williams
& Wilkins, 1992:155
-214
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Introduction
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