title: Three-dimensional CT Venography: A Diagnostic Modality for the Preoperative Assessment of Patients with Varicose Veins.
abstract: OBJECTIVE
  We preoperatively assessed varicose veins by means of computed tomography (CT) with contrast injection in the veins of the lower extremity (CT venography). This paper reports the procedures, results and implications of CT venography from the surgical aspect.
  
  
  METHODS
  A total of 48 legs in 39 patients were examined. Contrast medium was diluted ten-fold and injected into the lower extremity veins, often using a dual route of injection. The images were reconstructed with the volume-rendering method.
  
  
  RESULTS
  CT venography clearly visualized the veins with a small amount of contrast medium and facilitated the identification of anatomy that was not suitable for passing the stripper. In addition, CT venography helped identify unusual types of varicose veins or uncommon sites of inflow of small saphenous veins. Such information was helpful for avoiding unexpected vascular injury or for minimizing skin incision. Dual-route injection was beneficial to minimize the blind zones. Doppler ultrasound could be more focused on hemodynamic assessment and determination of incision sites.
  
  
  CONCLUSIONS
  CT Venography is feasible in all cases of varicose veins. When performed in conjunction with ultrasonography, it appears to facilitate the safe and efficient treatment of various types of varicose veins.
authors.affiliation: Department of Surgery, Division of Clinical Medical Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Sato
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Orihashi
authors.forename: Shinya
authors.initials: S
authors.lastname: Takahashi
authors.forename: Taiichi
authors.initials: T
authors.lastname: Takasaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kurosaki
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Imai
authors.forename: Minoru
authors.initials: M
authors.lastname: Ishifuro
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
keywords: computed tomography; varicose vein; venography
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