ABSTRACT
We evaluated 16-detector-row CT in the assessment of occlusive peripheral arterial disease (PAD) of the abdominal aorta and lower extremities using an adaptive method of acquisition to optimise arterial enhancement especially for the distal foot arteries. Thirty-four patients underwent transcatheter angiography (TCA) and CT angiography within 15 days. For each patient, table speed and rotation were selected according to the calculated optimal transit time of contrast material obtained after a single bolus test and two dynamic acquisitions at aorta and popliteal arteries. Analysis included image quality and detection of stenosis equal or greater than 50% on a patient basis and on an arterial segment basis. Sensitivity and specificity of CT were calculated with the TCA considered as the standard of reference. CT was conclusive in all segments with no technical failures even in difficult cases with occluded bypasses and aneurysms. On patient-basis analysis, the overall sensitivity and specificity to detect significant stenosis greater than 50% were both 100%. Segmental analysis shows high values of sensitivity and specificity ranging from 91 to 100% and from 81 to 100%, respectively, including distal pedal arteries. Sixteen-detector-row CT angiography using an adaptive acquisition improves the image quality and provides a reliable non-invasive technique to assess occlusive peripheral arterial disease, including distal foot arteries.
Subject(s)
Aorta, Abdominal/diagnostic imaging , Arterial Occlusive Diseases/diagnosis , Leg/blood supply , Leg/diagnostic imaging , Peripheral Vascular Diseases/diagnosis , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Contrast Media/administration & dosage , Female , Femoral Artery/diagnostic imaging , Humans , Iliac Artery/diagnostic imaging , Image Processing, Computer-Assisted , Iohexol , Male , Middle Aged , Popliteal Artery/diagnostic imaging , Radiographic Image Enhancement/methods , Reproducibility of Results , Sensitivity and Specificity , Tibial Arteries/diagnostic imagingABSTRACT
Recent advances in multi-detector CT technology, improving the spatial resolution and the acquisition time, provide basis for CT-angiography of the abdominal aorta and peripheral vessels of the lower extremities. The objective of this review is to help the clinician to understand principle of CT-angiography of peripheral vessels and to provide an overview of the current clinical applications as well as the futures directions in diagnosis, treatment planning and post-therapeutic surveillance in peripheral vascular diseases.