Combined CT venography and pulmonary angiography in suspected thromboembolic disease: diagnostic accuracy for deep venous evaluation.
OBJECTIVE
Combined CT venography and pulmonary angiography is a new diagnostic test that evaluates both pulmonary embolism and deep venous thrombosis (DVT) in a single study. Our purpose was to compare the CT venous findings with lower extremity venous sonography.


METHODS
Seventy-one consecutive patients with suspected pulmonary embolism underwent helical CT pulmonary angiography during rapid i.v. infusion of contrast medium. Axial scans at 5-cm intervals from the patient's upper calves to the diaphragm were generated 3.5 min after the beginning of contrast medium injection. CT venous phase images were interpreted prospectively and compared with subsequent bilateral lower extremity venous sonography performed within 12 hr.


RESULTS
DVT was revealed by CT venous phase images in 19 patients, 12 of whom also had pulmonary embolism. CT and sonographic findings correlated exactly in the femoropopliteal deep venous system, where most pulmonary emboli originate. CT venous phase images also revealed pelvic extension of DVT in six patients and isolated vena cava thrombus in one patient.


CONCLUSIONS
CT venous phase imaging at the time of CT pulmonary angiography is comparable with venous sonography in the evaluation of femoropopliteal DVT. The iliac veins and vena cava, vessels poorly shown on sonography but sometimes the source of significant pulmonary emboli, are also depicted by CT venography.
Loud
P A
PA
Department of Radiology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
Katz
D S
DS
Klippenstein
D L
DL
Shah
R D
RD
Grossman
Z D
ZD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006801:Humans; D007275:Injections, Intravenous; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011152:Popliteal Vein / Q000000981:diagnostic imaging; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014680:Veins / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*
D003287:Contrast Media