Venograp
hy
Presented by:
Syed Dawood (9050) Samreen Murad
(9206)
Ayesha Sultana(8902) Laiba Sharif (8947)
Naveed Ayub (8979)
Presented to:
Ma'am Minahil
Department of
Radiology
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A detailed introduction to venography procedure and techniques with step by step guide, indications, contraindications and patient preparation
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2025/2026
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Venograp
hy
Presented by: Syed Dawood (9050) Samreen Murad (9206) Ayesha Sultana (8902) Laiba Sharif (8947) Naveed Ayub (8979) Presented to: Ma'am Minahil
Department of
Radiology
What is Venography ? Venography (also called phlebography) is an imaging technique that uses contrast dye injected into a vein to visualize the venous system on X- rays, CT, or MRI. It helps diagnose blockages, clots, or abnormalities in veins. Purpose
- (^) To study the structure and function of veins
- (^) To identify conditions that affect venous flow
- (^) To guide treatment such as surgery or catheter placement
Types of Venography Conventional (Contrast) Venography
- (^) Dye injected → X-ray images taken using fluoroscopy
- (^) Considered the “gold standard” for diagnosing DVT CT Venography
- (^) Contrast-enhanced CT scan
- (^) Provides detailed cross- sectional images MR Venography
- (^) Uses magnetic resonance imaging
- (^) Good for patients who cannot take iodinated contrast
Indications (When Venograph y is Needed)
- (^) Suspected Deep Vein Thrombosis (DVT) When ultrasound is unclear or negative but suspicion remains high
- (^) Venous obstruction or stenosis Example: tumors compressing major veins
- (^) Varicose veins & venous insufficiency assessment
- (^) Congenital venous anomalies E.g., Klippel–Trénaunay syndrome
- (^) Pre-operative mapping For bypass grafts or dialysis access
- (^) Assessment before endovenous ablation
Procedure & Techniques Equipment
- (^) Venogram table with fluoroscopy
- (^) Contrast agent (iodinated dye)
- (^) IV cannula (typically 20–22 gauge)
- (^) Tourniquets
- (^) Sterile syringes and catheters
- (^) Imaging workstation
Patient Preparation
- (^) Obtain informed consent
- (^) Check for contrast allergies
- (^) Kidney function tests (creatinine, eGFR)
- (^) Hydrate patient before and after
- (^) Remove tight clothing/jewelry
- (^) Explain the sensation of contrast (“warm feeling”)
- (^) Intravenous cannula placement
- (^) Ensure no active infection
Interpretation of Results
Normal Findings
- (^) Clear outline of veins
- (^) Smooth vessel walls
- (^) Even flow of contrast
- (^) No filling defects
- (^) Normal valve function
Abnormal Findings
Deep Vein Thrombosis (DVT)
- (^) “Filling defect” (contrast does not fill the vein)
- (^) Abrupt cut-off of vein
- (^) Collateral veins may be visible Venous Insufficiency
- (^) Reflux of contrast downward
- (^) Dilated, tortuous veins
- (^) Valve incompetence Venous Obstruction / Stenosis
- (^) Narrowing of veins
- (^) Slow movement of contrast
- (^) Collateral channels forming
Advantages Limitations
- (^) Gold standard for detecting DVT
- (^) Very detailed venous anatomy
- (^) Useful when ultrasound is unclear
- (^) Helps surgeons and interventional radiologists plan procedures
- (^) Can evaluate deep pelvic and abdominal veins better than ultrasound - (^) Invasive - (^) Pain at injection site - (^) Requires contrast dye - (^) Risk of complications - (^) Not ideal for patients with kidney disease - (^) Ultrasound is safer and often preferred initially