Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Three-Dimensional Evaluation of the Anatomic Variations of the Femoral Vein and Popliteal Vein in Relation to the Accompanying Artery by Using CT Venography

  • Park, Eun-Ah (Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital) ;
  • Chung, Jin-Wook (Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital) ;
  • Lee, Whal (Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital) ;
  • Yin, Yong-Hu (Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital) ;
  • Ha, Jong-Won (Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Kim, Sang-Joon (Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital) ;
  • Park, Jae-Hyung (Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital)
  • Published : 2011.06.01
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Abstract

Objective: We wanted to describe the three-dimensional (3D) anatomic variations of the femoral vein (FV) and popliteal vein (PV) in relation to the accompanying artery using CT venography. Materials and Methods: We performed a retrospective review of 445 bilateral (890 limbs) lower limb CT venograms. After the 3D relationship between the FV and PV and accompanying artery was analyzed, the presence or absence of variation was determined and the observed variations were classified. In each patient, the extent and location of the variations and the location of the adductor hiatus were recorded to investigate the regional frequency of the variations. Results: There were four distinct categories of variations: agenesis (3 limbs, 0.3%), multiplication (isolated in the FV: 190 limbs, 21%; isolated in the PV: 14 limbs, 2%; and in both the FV and PV: 51 limbs, 6%), anatomical course variation (75 limbs, 8%) and high union of the tibial veins (737 limbs, 83%). The course variations included medial malposition (60 limbs, 7%), anterior rotation (11 limbs, 1%) and posterior rotation (4 limbs, 0.4%). Mapping the individual variations revealed regional differences in the pattern and frequency of the variations. Conclusion: CT venography helps to confirm a high incidence of variations in the lower limb venous anatomy and it also revealed various positional venous anomalies in relation to the respective artery.

Keywords

References

  1. Gordon AC, Wright I, Pugh ND. Duplication of the superficial femoral vein: recognition with duplex ultrasonography. Clin Radiol 1996;51:622-624 https://doi.org/10.1016/S0009-9260(96)80055-9
  2. Kerr TM, Smith JM, McKenna P, Lutter KS, Sampson MG, Helmchen RH, et al. Venous and arterial anomalies of the lower extremities diagnosed by duplex scanning. Surg Gynecol Obstet 1992;175:309-314
  3. Liu GC, Ferris EJ, Reifsteck JR, Baker ME. Effect of anatomic variations on deep venous thrombosis of the lower extremity. AJR Am J Roentgenol 1986;146:845-848 https://doi.org/10.2214/ajr.146.4.845
  4. May R. Surgery of the legs and veins of the leg and pelvis. Philadelphia, PA: Saunders, 1979:4
  5. Screaton NJ, Gillard JH, Berman LH, Kemp PM. Duplicated superficial femoral veins: a source of error in the sonographic investigation of deep vein thrombosis. Radiology 1998;206:397-401 https://doi.org/10.1148/radiology.206.2.9457192
  6. Thomas ML. Phlebography of the lower limb. New York, NY: Churchill Livingstone, 1982:162-163
  7. Dona E, Fletcher JP, Hughes TM, Saker K, Batiste P, Ramanathan I. Duplicated popliteal and superficial femoral veins: incidence and potential significance. Aust N Z J Surg 2000;70:438-440 https://doi.org/10.1046/j.1440-1622.2000.01855.x
  8. Quinlan DJ, Alikhan R, Gishen P, Sidhu PS. Variations in lower limb venous anatomy: implications for US diagnosis of deep vein thrombosis. Radiology 2003;228:443-448 https://doi.org/10.1148/radiol.2282020411
  9. Uhl JF, Gillot C. Embryology and three-dimensional anatomy of the superficial venous system of the lower limbs. Phlebology 2007;22:194-206 https://doi.org/10.1258/026835507782101717
  10. Lee W, Chung JW, Yin YH, Jae HJ, Kim SJ, Ha J, et al. Three-Dimensional CT venography of varicose veins of the lower extremity: image quality and comparison with Doppler sonography. AJR Am J Roentgenol 2008;191:1186-1191 https://doi.org/10.2214/AJR.07.3471
  11. Byun SS, Kim JH, Kim YJ, Jeon YS, Park CH, Kim WH. Evaluation of deep vein thrombosis with multidetector row CT after orthopedic arthroplasty: a prospective study for comparison with Doppler sonography. Korean J Radiol 2008;9:59-66 https://doi.org/10.3348/kjr.2008.9.1.59
  12. Uhl JF, Gillot C, Chahim M. Anatomical variations of the femoral vein. J Vasc Surg 2010;52:714-719 https://doi.org/10.1016/j.jvs.2010.04.014
  13. Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H. Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg 2005;41:719-724 https://doi.org/10.1016/j.jvs.2005.01.018
  14. Dodd H, Cockett FB. The pathology and surgery of the veins of the lower limb, 2nd ed. Edinburgh, Scotland: Churchill Livingstone, 1976:31-32
  15. Quinn KL, Vandeman FN. Thrombosis of a duplicated superficial femoral vein. Potential error in compression ultrasound diagnosis of lower extremity deep venous thrombosis. J Ultrasound Med 1990;9:235-238 https://doi.org/10.7863/jum.1990.9.4.235
  16. Rose SC, Zwiebel WJ, Miller FJ. Distribution of acute lower extremity deep venous thrombosis in symptomatic and asymptomatic patients: imaging implications. J Ultrasound Med 1994;13:243-250 https://doi.org/10.7863/jum.1994.13.4.243
  17. Park EA, Lee W, Lee MW, Choi SI, Jae HJ, Chung JW, et al. Chronic-stage deep vein thrombosis of the lower extremities: indirect CT venographic findings. J Comput Assist Tomogr 2007;31:649-656 https://doi.org/10.1097/RCT.0b013e31803151d9

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