title: Analysis of deep inferior epigastric perforator (DIEP) arteries by using MDCTA: Comparison between 2 post-processing techniques.
abstract: OBJECTIVE
  Our purpose was to compare two post-processing techniques, Maximum-Intensity-Projection (MIP) and Volume Rendering (VR) for the study of perforator arteries.
  
  
  METHODS
  Thirty patients who underwent Multi-Detector-Row CT Angiography (MDCTA) between February 2010 and May 2010 were retrospectively analyzed. For each patient and for each reconstruction method, the image quality was evaluated and the inter- and intra-observer agreement was calculated according to the Cohen statistics. The Hounsfield Unit (HU) value in the common femoral artery was quantified and the correlation (Pearson Statistic) between image quality and HU value was explored.
  
  
  RESULTS
  The Pearson r between the right and left common femoral artery was excellent (r=0.955). The highest image quality score was obtained using MIP for both observers (total value 75, with a mean value 2.67 for observer 1 and total value of 79 and a mean value of 2.82 for observer 2). The highest agreement between the two observers was detected using the MIP protocol with a Cohen kappa value of 0.856. The ROC area under the curve (Az) for the VR is 0.786 (0.086 SD; p value=0.0009) whereas the ROC area under the curve (Az) for the MIP is 0.0928 (0.051 SD; p value=0.0001).
  
  
  CONCLUSIONS
  MIP showed the optimal inter- and intra-observer agreement and the highest quality scores and therefore should be used as post-processing techniques in the analysis of perforating arteries.
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria, di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy. lucasaba@tiscali.it
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.forename: Matteo
authors.initials: M
authors.lastname: Atzeni
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Mallarini
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Suri
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000792:Angiography / Q000379:methods*; D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods*