Diagnostic Value of Combined Multislice Spiral CT Venography and Pulmonary Angiography in Deep Venous Thrombosis

Objective To study the incidence and locations of deep venous thrombosis(DVT) by using 16-slice spiral CT venography in combination with pulmonary angiography(CTVPA).The accuracy of DVT in lower extremities by CT venography(CTV) was compared with color Doppler ultrasound.Methods 147 patinets with clinically suspected pulmonary embolism underwent CTVPA.The interobserver agreement in two doctors were assessed based on a patient as unit in diagnosing DVT.The results of CTV were compared with the ultrasonic results of DVT in lower extremities.Results DVT were diagnosed in 33 patients,among which 27 patients had been combined PTE and 6 patients without PTE.156 thrombi were detected in 33 patients,among which 48 thrombi(31%) were located in abdominal and pelvic veins,58 thrombi(37%) were located in femoropopliteal veins and the other 50 thrombi(32%) were located in the calf veins.The CT value ofDVT was(42±13) HU.Agreement of diagnosis was achieved in 90% patients.The Kappa was 0.86.The sensitivity and specificity were 92.3% and 100% in diagnosis of femoropopliteal venous thrombosis by CTV.Conclusion CTV is an accurate method in the diagnosis of femoropopliteal venous thrombosis and can also reveal the thrombosis in the inferior vena cava,filter and iliac veins.The interobserver agreement is very good.