title: Underlying deep venous abnormalities in patients with unilateral chronic venous disease.
abstract: OBJECTIVE
  To report our initial experience using direct multidetector computed tomography venography (MDCT-V) for imaging lower limb deep veins. CT findings in limbs with chronic venous disease (CVD) were compared with contralateral healthy limbs.
  
  
  METHODS
  MDCT-V with bilateral direct pedal injection of contrast was used to image the deep veins in both lower limbs. Eight patients with unilateral lower limb CVD of varying severity (according to the Clinico-Etiological-Anatomical and Pathological classification [CEAP] class 2-6) were studied. Five patients had primary CVD, while three patients had CVD secondary to previous deep vein thrombosis.
  
  
  RESULTS
  Deep venous obstruction (>50%) or occlusion was identified in all CVD limbs and was not seen in contralateral healthy limbs. These lesions were not only iliac, were not exclusively present in advanced CVD and were independent of the presence or absence of deep venous reflux.
  
  
  CONCLUSIONS
  Morphologically significant lesions could be underlying in patients with clinically significant CVD. Direct MDCT-V provides clear reconstructable cross-sectional images of the whole deep venous tree, including infrainguinal areas, beyond the reach of intravascular ultrasound. Utilization of new venous imaging modalities may uncover previously undiagnosed and potentially treatable venous pathology in patients with CVD.
authors.affiliation: Department of Vascular Surgery.
authors.forename: A S
authors.initials: AS
authors.lastname: Gaweesh
authors.forename: M H
authors.initials: MH
authors.lastname: Kayed
authors.forename: T Y
authors.initials: TY
authors.lastname: Gaweesh
authors.forename: J
authors.initials: J
authors.lastname: Shalhoub
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
authors.forename: H M
authors.initials: HM
authors.lastname: Khamis
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003251:Constriction, Pathologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*