title: [Diagnostic accuracy of dual energy CT angiography in patients with diabetes mellitus].
abstract: OBJECTIVE
  Peripheral arterial disease (PAD) represents a major and highly prevalent complication in patients with diabetes mellitus. The diagnostic, non-invasive work-up by computed tomography angiography (CTA) is limited in the presence of extensive calcification. The aim of the study was to determine the diagnostic accuracy of dual energy CTA (DE-CTA) for the detection and characterization of PAD in patients with diabetes mellitus.
  
  
  METHODS
  In this study 30 diabetic patients with suspected or known PAD were retrospectively included in the analysis. All subjects underwent DE-CTA (Somatom Definition Flash, Siemens Healthcare, Erlangen, Germany) prior to invasive angiography, which served as the reference standard. Blinded analysis included assessment of the presence and degree of peripheral stenosis on curved multiplanar reformatting (MPR) and maximum intensity projections (MIP). Conventional measures of diagnostic accuracy were derived.
  
  
  RESULTS
  Among the 30 subjects included in the analysis (83% male, mean age 70.0 ± 10.5 years, 83% diabetes type 2), the prevalence of critical stenosis in 331 evaluated vessel segments was high (30%). Dual energy CT identified critical stenoses with a high sensitivity and good specificity using curved MPR (100% and 93.1%, respectively) and MIP images (99% and 91.8%, respectively). In stratified analysis, the diagnostic accuracy was higher for stenosis pertaining to the pelvic and thigh vessels as compared with the lower extremities (curved MPR accuracy 97.1% vs. 99.2 vs. 90.9%; respectively, p < 0.001).
  
  
  CONCLUSIONS
  The use of DE-CTA allows reliable detection and characterization of peripheral arterial stenosis in patients with diabetes mellitus with higher accuracy in vessels in the pelvic and thigh regions compared with the vessels in the lower legs.
authors: Abteilung für Diagnostische und Interventionelle Radiologie, Klinikum der Eberhard-Karls-Universität, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland, christoph.schabel@med.uni-tuebingen.de.
authors: C
authors: C
authors: Schabel
authors: M N
authors: MN
authors: Bongers
authors: D
authors: D
authors: Ketelsen
authors: R
authors: R
authors: Syha
authors: C
authors: C
authors: Thomas
authors: G
authors: G
authors: Homann
authors: M
authors: M
authors: Notohamiprodjo
authors: K
authors: K
authors: Nikolaou
authors: F
authors: F
authors: Bamberg
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*