상지의 Direct Injection CT Venogram의 유용성에 대한 고찰

Inspection for Benefit of The Direct Injection Upper Extremity CT Venogram

Purpose The purpose of this study was to recognize the benefit of the direct injection upper extremity venogram in obstructive disease of the vein, because of the indirect venogram has a diagnostic limitation. Materials and methods It is suspected that 17 patients to be the obstructive disease of the vein(stenosis, occlusion, thrombus), that were examined within 88 patients of ordering extremity VCTA with swelling, since June, 2006. until June, 2008, and 13 patients(76.5%) were males, 4 patients(23.5%) were females. For the comparison, 19 patients(12 patients(63.2%) were males, 7 patients(36.8%) were females) were suspected to be the similar disease, and were examined. Contrast media(CM) of direct venogram was made use of mixed CM and saline in the rate of 1 to 2, total volume was 160ml, and injected into the back of the hand toward the finger direction, and injected into the injection speed of 1.5 ml/sec with bending wrist level. When the 75%(120ml) of the CM was injected, removed the toniquet, examined from finger tip to shoulder after 5secs. And evaluated the result from intervention radiologist. Results 13 patients were confirmed obstructive disease, 4 patients were not confirmed disease, within 17 patients. 14 patients could be evaluated both of the cephalic vein and brachial vein, but 3 patients could be evaluated only brachial vein. In the contrary, 9 patients were confirmed obstructive disease, 4 patients were normal, 6 patients were not confirmed disease, within 19 patients, in indirect venogram. But 3 cases of unconfirmed patients, were confirmed by direct venogram. Conclusion Indirect venogram has merit of the evaluation of the arteries, veins and around the structure, but has a weak point, that can not be distinguish from structure of disease clearly in obsructive disease. To the contrary, direct venogram has a weak point, that can not make an observation clearly except vein system, but it is very useful to evaluate the vein system.