MDCT compared with digital subtraction angiography for assessment of lower extremity arterial occlusive disease: importance of reviewing cross-sectional images.
OBJECTIVE
The aim of our study was to evaluate the efficacy of MDCT angiography in the assessment of lower limb peripheral arterial occlusive disease.


METHODS
Twenty-four patients (representing 27 cases) with symptomatic lower extremity peripheral arterial occlusive disease underwent both MDCT angiography and digital subtraction angiography of the aortoiliac and lower extremity arteries. For data analysis, the arterial system was divided into 10 segments. Each segment was classified as normal, mildly stenotic, moderately stenotic, severely stenotic, or occluded. In evaluating MDCT angiographic findings, cross-sectional images were mainly observed by scrolling. The diagnostic accuracy of MDCT angiography was determined, using digital subtraction angiography as the standard reference. The extent of calcification in each segment was also assessed on MDCT angiography and was classified as absent, mildly calcified, or severely calcified.


RESULTS
Of the 480 segments studied, 470 were assessable on both digital subtraction angiography and MDCT angiography. On digital subtraction angiography, 142 stenoocclusive segments (20 mildly stenotic, 14 moderately stenotic, 25 severely stenotic, and 83 occluded) were detected. With regard to the detection of segments that had more than mild stenosis, the sensitivity, specificity, and accuracy of MDCT angiography were 99.2%, 99.1%, and 99.1%, respectively. In the 421 noncalcified and mildly calcified segments, the sensitivity, specificity, and accuracy of MDCT angiography for the detection of more-than-mild stenosis were 100%, 100%, and 100%, respectively.


CONCLUSIONS
MDCT angiography is a reliable method for evaluating the aortoiliac and lower extremity arteries.
Ota
Hideki
H
Department of Radiology, Ishinomaki Red Cross Hospital, 1-7-10 Yoshino, Ishinomaki, Miyagi 986-8522, Japan.
Takase
Kei
K
Igarashi
Kazumasa
K
Chiba
Yoshihiro
Y
Haga
Kenichi
K
Saito
Haruo
H
Takahashi
Shoki
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed