CT angiography of the lower extremity and coronary arteries using 256-section CT: a preliminary study.
OBJECTIVE
To investigate the possible use of a 256-section computed tomography (CT) prospective electrocardiography (ECG)-gated wide volume scanning protocol for combined angiography of the lower extremity and coronary arteries, after a single injection of contrast medium, in patients with lower extremity peripheral arterial disease (PAD).


METHODS
Thirty-four patients with suspected PAD underwent CT angiography (CTA) with a prospective ECG-gated protocol that covered the level of the tracheal bifurcation to the foot sole. Digital subtraction angiography (DSA) of the lower extremity arteries was performed on patients requiring therapeutic intervention. Image quality and stenosis of the coronary and lower extremity arteries were assessed.


RESULTS
A total of 93.1% of the coronary segments were adequate for diagnosis. 17 (50%) patients showed coronary artery stenosis ≥50%. A total of 95.8% of the lower extremity arterial segments were adequate for diagnosis. Twenty-eight patients with severe lower extremity arterial stenosis or occlusion underwent DSA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CTA for the detection of significant lower arterial stenosis (≥50%) was 94.8%, 97.2%, 95.3%, 96.9%, and 96.3%, respectively.


CONCLUSIONS
Using the prospective ECG-gated wide volume CTA protocol, images of the coronary and lower extremity arteries suitable for diagnosis can be acquired simultaneously after a single injection of contrast agent. In addition to accurately diagnosing PAD, combined angiography may be used to screen for coronary heart disease in patients with PAD.
Department of Computer Tomography, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
D
D
Xie
Department of MRI, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
J
J
Na
Department of Computer Tomography, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
M
M
Zhang
Department of Computer Tomography, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
S
S
Dong
Department of Computer Tomography, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China. Electronic address: medscixdx@126.com.
X
X
Xiao
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D055424:Cardiac-Gated Imaging Techniques; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods