Unusual Causes of Varicose Veins in the Lower Extremities: CT Venographic and Doppler US Findings

There are various causes of varicose veins in the lower extremities. Among the causes are venous insufficiency of the saphenofemoral junction, saphenopopliteal junction, or usual perforating veins. Traditionally, Doppler ultrasonography (US) has been used for evaluation of varicose veins. Sometimes, varicose veins arise from an unexpected anatomic source; in these cases, computed tomographic (CT) venography can provide an overview of the varicose veins. Doppler US with complementary CT venography is useful for determining the precise cause of varicose veins. Between November 2003 and March 2008, the authors evaluated 1350 cases of varicose veins in the lower extremities with both CT venography and Doppler US. The varicose veins were classified according to their causes; unusual causes were studied and included vulvoperineal varicosity, intraosseous perforating vein incompetence, round ligament varicosity, persistent sciatic vein incompetence, Klippel-Trenaunay syndrome, and portosystemic collateral pathways. Radiologists should be familiar with the complete range of primary causes of varicose veins in the lower extremities and with their radiologic manifestations and should recognize the complementary role of CT venography in their evaluation.Nguyen QH, 2008, J CLIN ULTRASOUND, V36, P177, DOI 10.1002/jcu.20399Bastarrika G, 2007, J AM ACAD DERMATOL, V56, P242, DOI 10.1016/j.jaad.2006.08.057Fassiadis N, 2006, INT ANGIOL, V25, P1Chi C, 2005, ACTA OBSTET GYN SCAN, V84, P1126Hobbs JT, 2005, INT J CLIN PRACT, V59, P1195, DOI 10.1111/j.1368-5031.2005.00631.xLee A, 2005, PEDIATRICS, V115, P744, DOI 10.1542/peds.2004-0446Pilkington SA, 2004, ANN ROY COLL SURG, V86, P400Golledge J, 2003, EUR J VASC ENDOVASC, V25, P319, DOI 10.1053/ejvs.2002.1843Parry DJ, 2002, J VASC SURG, V36, P396, DOI 10.1067/mva.2002.125844PEIRCE RM, 2002, AM J ROENTGENOL, V178, P513Guillem P, 2001, ACTA CHIR BELG, V101, P310Henseler KP, 2001, RADIOGRAPHICS, V21, P691Noel AA, 2000, J VASC SURG, V32, P840Peh WCG, 2000, BRIT J RADIOL, V73, P80Venbrux AC, 1999, CURR OPIN OBSTET GYN, V11, P395Biesecker LG, 1999, AM J MED GENET, V84, P389Hamilton HEC, 1999, EUR J VASC ENDOVASC, V17, P539Diaz-Candamio MJ, 1999, J COMPUT ASSIST TOMO, V23, P328Jacob AG, 1998, MAYO CLIN PROC, V73, P28HUANG A, 1998, J OBSTET GYNAECOL, V18, P284Ahn J, 1997, BRIT J RADIOL, V70, P1302Porpora MG, 1997, FERTIL STERIL, V68, P765Cheng D, 1997, ULTRASOUND OBST GYN, V9, P198Boutin RD, 1997, RADIOLOGY, V202, P751Cherry KJ, 1996, J VASC SURG, V23, P490CHO KC, 1995, RADIOGRAPHICS, V15, P609ALQUDAH MS, 1993, POSTGRAD MED J, V69, P820KNYCH SA, 1992, CLIN ORTHOP RELAT R, P307DUBOIS JM, 1991, RADIOLOGY, V180, P195HOBBS JT, 1990, BRIT J HOSP MED, V43, P200TRIGAUX JPF, 1989, CARDIOVASC INTER RAD, V12, P103DALPOS R, 1988, CHIR ITAL, V40, P83SERVELLE M, 1985, ANN SURG, V201, P365LAFORTUNE M, 1985, AM J ROENTGENOL, V144, P549BASKERVILLE PA, 1985, ANN SURG, V202, P624MCCAIN AH, 1985, RADIOLOGY, V154, P63FREDE TE, 1984, J ULTRAS MED, V3, P365BURROWS PE, 1983, AM J ROENTGENOL, V141, P483KATZEN BT, 1981, AM J ROENTGENOL, V136, P427LEBREC D, 1980, GASTROENTEROLOGY, V79, P1139BLIZNAK J, 1974, RADIOLOGY, V110, P35