16-MDCT angiography of aortoiliac and lower extremity arteries: comparison with digital subtraction angiography.
OBJECTIVE
The objective of our study was to prospectively compare CT angiography (CTA) performed on a 16-MDCT scanner and digital subtraction angiography (DSA) in patients with peripheral arterial disease.


METHODS
CTA and DSA were compared in 50 patients. CTA was independently evaluated by two blinded observers. DSA was evaluated by two additional blinded observers in consensus. Consensus DSA served as the reference standard for comparisons with CTA in terms of diagnostic quality, grading of stenoocclusive lesions, visualization of collaterals, impact on patient management, and time required for analysis.


RESULTS
No significant differences in diagnostic quality were observed between CTA and DSA above the ankle; both CTA observers noted significantly better visualization of pedal arteries (70 and 72 segments, respectively) than on DSA (57 segments). Of 958 stenoocclusive lesions on DSA, CTA observers 1 and 2 detected 933 and 929 lesions, respectively. Sensitivity and specificity for the detection of hemodynamically relevant (> 50%) lesions was 93.3% and 96.5% for observer 1 and 90.1% and 95.6% for observer 2. Collaterals were seen at 150 arterial levels on DSA compared with 97 and 92 levels on CTA (p < 0.05, both observers). Patient management decisions based on CTA were equivalent to those based on DSA in 49 of the 50 patients.


CONCLUSIONS
CTA is an effective noninvasive alternative to DSA for the evaluation of peripheral arterial disease.
Albrecht
Thomas
T
Department of Radiology and Nuclear Medicine, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Freie Universität Berlin, Germany. thomas.albrecht@charite.de
Foert
Ellen
E
Holtkamp
Robin
R
Kirchin
Miles A
MA
Ribbe
Constanze
C
Wacker
Frank K
FK
Kruschewski
Martin
M
Meyer
Bernhard C
BC
D000368:Aged; D000792:Angiography / Q000379:methods; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001027:Aortography / Q000379:methods; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply / Q000000981:diagnostic imaging; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*