Comparison between 64-row CT angiography and digital subtraction angiography in the study of lower extremities: personal experience

• Published in: Radiologia medica Vol. 114; no. 7; pp. 1115 - 1129
• Main Authors: Cernic, S., Pozzi Mucelli, F., Pellegrin, A., Pizzolato, R., Cova, M. A.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.10.2009
• Subjects: Aged; Aged, 80 and over; Angiography - methods; Angiography, Digital Subtraction - methods; Diagnostic Radiology; Female; Humans; Image Processing, Computer-Assisted; Imaging; Interventional Radiology; Knee - diagnostic imaging; Leg - diagnostic imaging; Lower Extremity - blood supply; Lower Extremity - diagnostic imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Peripheral Vascular Diseases - diagnostic imaging; Predictive Value of Tests; Radiographic Image Interpretation, Computer-Assisted; Radiologia Vascolare ed Interventistica; Radiology; Retrospective Studies; Sensitivity and Specificity; Thigh - diagnostic imaging; Tomography, X-Ray Computed - methods; Ultrasound; Vascular and Interventional Radiology; Peripheral arterial occlusive disease; Digital angiography; Angiografia digitale; Arteriopatia ostruttiva arti inferiori; 64-row multislice computed tomography; Tomografia computerizzata a 64 strati
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-009-0457-8

Purpose This study was undertaken to evaluate the potential of 64-row multislice computed tomography (CT) versus digital subtraction angiography (DSA) in detecting significant lesions of lower-extremity inflow and runoff arteries. Materials and methods Fifty-three patients underwent 64-row multislice CT and DSA over a mean of 36 days. The vascular tree was divided into 33 segments. Three readers independently reviewed the axial CT scans and multiplanar oblique and two- and three-dimensional reconstructions (maximum intensity projection and volume rendering) images to assess degree of stenosis according to four categories: 1 (0%–49% stenosis); 2 (50%–99% stenosis); 3 (occluded); 4 (not evaluable). In all cases, DSA was performed by arterial catheterisation. Results In 53 patients, 1,440 segments were evaluated (infrarenal aorta and 16 arterial segments for each leg; 42 bilateral studies, 11 unilateral studies). Compared with DSA, CT angiography yielded 97.2% sensitivity, 97% specificity, 92.5% positive predictive value, 98.9% negative predictive value, 97.1% diagnostic accuracy and 95.4% concordance on the degree of stenosis. Conclusions Sixty-four-row multislice CT proved to be helpful in detecting haemodynamically significant lesions in peripheral arterial occlusive disease and improved the results obtained with 4- and 16-slice multidetector CT. In addition, owing to the high spatial resolution and rigorous technique, no variations in the data obtained below the knee were detected, overcoming a limitation of earlier generations of CT scanners.