Three-dimensional spiral CT venography for the pre-operative assessment of varicose patients.
BACKGROUND
The purpose of pre-operative spiral CT venography or veno-CT (VCT) is to provide a precise 3D anatomic depiction of the venous network, to be used as a guideline by the surgeon.


METHODS
A multislice and multidetector spiral CT acquisition of the lower limb with diluted contrast injection produces about 400 slices in 30 s. Dedicated volume-rendering software compute interactive 3D images of the venous system. Dynamic data are easily exported by e-mail and available for phlebologists and surgeons. As VCT provides no hemodynamic data, an associated color-coded duplex is mandatory.


RESULTS
VCT is useful in case of post-operative recurrence (especially of the popliteal fossa), high or dystrophic termination of the short saphenous vein, varices feeded by the Giacomini vein, and to investigate pelvic or pudental varicose veins. A full knowledge of the complex venous networks is possible thanks to interactivity of the resulting 3D model, using rotation and modification of transparency of the tissues.


CONCLUSIONS
Providing a more complete anatomical information, VCT makes possible a better surgical choice of technique, avoiding anatomic pitfalls, with a more precise and limited skin approach. Accordingly, it may hopefully improve the aesthetic result as well as the efficacy, by reducing the varicose veins recurrence rate.
Uhl
J F
JF
Varicose Vein Surgical Center, Neuilly, France. jfuhl@compuserve.com
Verdeille
S
S
Martin-Bouyer
Y
Y
D000328:Adult; D034742:Electronic Mail; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D010348:Patient Care Team; D010690:Phlebography; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012008:Recurrence; D012984:Software; D036542:Tomography, Spiral Computed; D018615:Ultrasonography, Doppler, Color; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000601:surgery*