Aim: To determine the effectiveness of CT venography (CTV) in diagnosis and establishment of treatment policy for crural stasis ulcer. Object and method: The study selected 12 legs of 11 cases of non-healing (CEAP C6) among 270 legs of 227 cases that underwent surgical operation for varicosity. Contrast medium was administered from veins of upper limbs by using 16-row MDCT. Obtained axial images were structured into 2D cine and perforator veins were recorded in 3D images. Result: Duplex scan examination was diffi cult with three widespread ulcerated limbs. Using CTV it was possible to detect perforator veins with all limbs but not possible to diagnose regurgitation and valvular incompetence. Summary: CTV does not offer function test capability, but is excellent in objectivity and reproducibility as it enables physicians to grasp the big picture of veins in lower extremities in a short span of time although veins in the lower extremities are not subjected to pressure as they are in a real life because measurements are taken in the supine position. For widespread ulcer that duplex scan alone does not provide accurate diagnosis of incomplete perforator veins, less invasive and precise diagnosis can be made on pathogenetic veins when combined with CTV tests.

Sixty-two patients with venous malformations underwent percutanous sclerotherapy with direct puncture and injection of 5% ethanolamine oleate or 1% polidocanol. The late results were excellent or good in 51 patients (82.3%), fair in 8, poor in 3. Of three poor cases, two cases were Klippel-Trenaunay syndrome. Complications of the treatment included soft tissue necrosis (16 sessions: 14.7%), hemoglobinuria (45 sessions: 41.3%). All cases with soft tissue necrosis were resolved conservatively. The healing time of skin necrosis (mean 58.6 days) was significantly longer than that of mucosal necrosis (mean 26.1 days). In conclusion, sclerotherapy with ethanolamine oleate or polidocanol is a safe and effective treatment for many cases with venous malformations. However, at this time, it is diffi cult to treat the lesions of the orbit or large malformations with Klippel-Trenaunay syndrome with safety and effect.

Superior mesenteric venous thrombosis (SMVT) is an uncommon cause of intestinal ischemia which is associated with a high degree of morbidity and mortality. The development of computed tomography has been making the diagnosis of this disease easier if we can outline this pathological state. We reviewed five SMVT patients in our hospital from 2000 to 2007 and discussed the clinical character. Though laboratory work up showed none of these patients had congenital or acquired thrombophilia, all patient were associated with some pathological states like inflammatory bowel disease, essential thrombocythemia, eosinophilic enteritis and acute pancreatitis which sometimes show hypercoagulability. Four patients showed acute abdomen and three of them underwent emergent operation. Characteristic abdominal findings in acute SMVT were severe abdominal pain with distension, without peritoneal sign at the beginning. Multidetector computer tomography revealed SMVT precisely. As D-dimer level elevated markedly in all acute SMVT patients, this would be helpful when diagnose acute SMVT. All patients were treated with early initiation of anticoagulant therapy especially with unfractionated heparin, whether they underwent further treatment or not. This would be important to minimize SMVT extension.

Fifty-four lower limbs of 27 healthy volunteers in control group and 80 limbs of 51 in varicose vein group patients were studied. Four cross sectional areas of deep veins were measured with duplex scanning. Each regions were measured before and after stripping surgery at both standing and lying position. We compared the difference in the cross sectional areas of the two groups, before and after surgery. We also compared the difference in the cross sectional area according to the severity of varicose veins defined by CEAP classification. At standing position the cross sectional area of popliteal vein was significantly larger in varicose vein group than that in control group. At lying position the cross sectional area of femoral vein was significantly larger in varicose vein group than that in control group. At this position the size of popliteal vein showed no difference between the two groups. After stripping surgery the size of deep vein significantly decreased. According to CEAP classification, severe varicose vein groups resulted with larger cross sectional area of femoral vein at standing position. These results suggested that the blood pooled in the superficial vein system affected the deep vein system. However, the affect of deep venous and perforater reflux on lower vein systems were not proved.

This paper is an introduction to the interventional radiology for the portal vein circulation. The developmental history of portography was studied and interventional procedure for the portal vein circulation were described. Compared with venography and arteriography, portography is 20–21 years behind. It is the main reason of the delay that portal vein is not visible and palpable. At present, it is no exaggeration to say that portography is only used in interventional procedure. New direct approaches are beeing created by the progress and the improvement of diagnostic tools (IVUS) and devices (stentgraft).