Chronic-stage deep vein thrombosis of the lower extremities: indirect CT venographic findings

To describe the computed tomographic (CT) findings of chronic deep vein thrombosis (DVT) and its evolution from acute DVT.

Fifty-one consecutive patients with 52 legs confirmed as acute DVT by CT venography underwent follow-up computed tomography more than 2 months later. Follow-up CT findings were assessed retrospectively by consensus between 2 radiologists. The frequencies of CT findings were analyzed for affected venous segments: common iliac, external iliac, femoral, popliteal, and calf veins.

Twelve legs (23%) were completely normalized on follow-up computed tomography, but 40 legs (77%) showed abnormal findings as follows: luminal obliteration (n = 16), decreased caliber (n = 30), residual thrombi (n = 3), fibrotic bands (n = 28), ipsilateral muscle enlargement (n = 28), ipsilateral subcutaneous edema (n = 11), and superficial collateral vein development (n = 23). The external iliac vein (26/40, 65%) was the most commonly affected site followed in decreasing order by femoral (29/50, 58%), common iliac (9/18, 50%), popliteal (22/47, 47%), and calf veins (9/43, 21%). Trends were observed whereby luminal obliteration affected iliac veins and fibrotic bands affected femoropopliteal veins.

Luminal obliteration, decreased caliber, fibrotic bands, ipsilateral muscle enlargement, and superficial collateral vein development are common CT findings in chronic DVT of the lower extremity.