Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography.
OBJECTIVE
The purpose of this study was to determine the accuracy of CT angiography using a multidetector scanner in the evaluation of patients with peripheral vascular disease.


METHODS
Eighteen patients with peripheral vascular disease who were referred for elective digital subtraction angiography (DSA) also underwent CT angiography. We scanned patients from the level of the superior mesenteric artery to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection reconstructions. Findings were graded according to six categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (75-99% stenosis); 5, occluded; and 6, nondiagnostic. CT angiography findings were compared with DSA findings for each arterial segment.


RESULTS
We found agreement for the degree of stenosis in 77.7% of the arteries and discrepancy for 22.3% of the arteries when all categories were considered. Grouping the six categories according to the threshold for treatment (categories 1 and 2 as one group and categories 3, 4, and 5 as the second group) resulted in an agreement of 91.95%. Compared with DSA, CT angiography yielded a sensitivity of 90.9% and a specificity of 92.4%.


CONCLUSIONS
Multidetector CT angiography is an accurate, noninvasive technique for the imaging of peripheral vascular disease.
Ofer
Amos
A
Department of Diagnostic Radiology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel.
Nitecki
Samy S
SS
Linn
Shai
S
Epelman
Monica
M
Fischer
Doron
D
Karram
Tony
T
Litmanovich
Diana
D
Schwartz
Henry
H
Hoffman
Aaron
A
Engel
Ahuva
A
D000368:Aged; D015901:Angiography, Digital Subtraction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed