Ascending CT venography and venous phase CT venography for diagnosis of deep venous thrombosis

Ascending computed tomographic (CT) venography was compared with conventional contrast venography combined with ultrasound and follow-up in 52 patients with suspected deep venous thrombosis (DVT). Ascending CT venography more clearly demonstrated extension of DVT into the pelvic veins and inferior vena cava than conventional contrast venography. The quality of ascending CT venography was superior to conventional venography in all veins. This chapter reviews the methods for CT venous phase imaging of the veins of the pelvis and lower extremities used in the prospective investigation of pulmonary embolism diagnosis II (PIOPED II). In patients with suspected acute pulmonary embolism (PE), the number of patients with PE on CT pulmonary angiography and the number only with DVT on venous phase CT venography are shown in the chapter. The Fleischner Society recommended the use of CT venography when emphasis must be placed on a complete vascular examination that can be accomplished expeditiously.