Testicular vein retroperitoneal in abdomen, visible on CT venography. Is it safe to have venography with moderate pulmonary sarcoidosis?
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1)Rt testicular vein is retroperitoneal in abdomen.is it visible in its full length in abdomen from XXXXXXX inguinal ring level to its drainage site inferior vena cava on abdominal ultrasound?.....2)Rt testicular vein is visible on ct venography but it has 2 or 3 branches in inginal canal.can these 2 or 3 branches can be seen separately and clearly in the inguinal canal region on 64 slice or 128 slice 3D ct venography?...........3)veins with diameter of 0.5mm on 64 slice ct and veins with diameter of 0.3mm on 128 slice ct can bee seen.is it right or these values are for arteries?.....what is the smallest vein diameter that can be seen on 64slice ct?what is smallest vein diameter seen on128 slice ct?.............4)what is the smallest vein diameter that can be seen on 3 tesla mri venography?is ct venography better than mri veonography to see small veins?...........5)if a patient has mild to moderate pulmonary sarcoidosis but no renal involvement and renal functions are normal.is it safe to have ct venography with iv contrast in that patient?...................6)can you send me images or videos showing testicular vein and its branches in the inguinal canal region on 3d ct venography to my e mail address or here?that will be a great help for me.thanks
Posted Sat, 7 Jul 2012 in TMJ
Answered by Dr. Mangesh Tarte 40 hours later
Thanks for your query. The following are my answers to your query.
1. To visualized testicular veins clearly one needs to do 'Testicular Phlebography' in Digital Subtraction Angiograpy (DSA) Cathlab to rule out abnormal veins or Inferior Venacava (IVC) Gram to locate testicular / Gonadal veins drainage if any. Abdominal ultrasound will not be sufficient to locate/visualize testicular vessels clearly.
Usually left testicular vein drains into left renal vein but not true for right testicular vein. We can only know this by a phlebography.
2&3&4. 64 & 128 slice Computed tomography (CT) scans & even 3 Tesla Magnetic Resonance Imaging (MRI) scan will not depict correct anatomy and venous drainage. Scanners have their own limitations but DSA study is crystal clear.
5. If renal function tests like serum creatinine are below 1.5mg/dl and blood urea nitrogen (BUN) and serum uric acid levels are within normal range then we can inject "non- ionic" contrast media like Inj.Ultravist-300/370 or Inj.Visipaqe & do Phlebography. The same applies to CT contrast scans too.
6. I am sorry; I do not have any images to share with you. Besides as I mentioned earlier, testicular vessels are best studied on phlebography. Alternatively one can go for 'Testicular & branch veins Embolisation' with Glue or Coils if abnormality like 'Gross Varicocele', malformations or AVM found and Patient has clinical symptoms of dragging testicular pains, heaviness, low sperm count, male sterility etc.
Hope this answers your query. Let me know if you need any more information.