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An en bloc approach to CT perfusion for the evaluation of limb ischemia

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Abstract

We examine volumetric CT perfusion in soft tissues of the entire foot with an en bloc technique to provide a meaningful measure of differentiation between mild and major vascular impairment. With Institutional Review Board approval, 22 healthy male subjects between the ages of 21 and 50 (mean 37) were enrolled. Volumetric computed tomography using an en bloc technique was conducted on 14 subjects for validation while unilateral vascular obstruction was simulated in the calves of the remaining 8 subjects. Perfusion estimates were made using in-house software and differences in perfusion estimates between feet were evaluated with Student’s t-test at 95% confidence. Subjects with simulated major vascular obstruction (calf blood pressure cuff inflated to 200 mmHg) showed significantly higher ratios of perfusion estimates between the unobstructed and obstructed foot compared to subjects with simulated mild vascular obstruction (cuff inflated to 120 mmHg), mean 4.6, SD 2.6 vs. mean 1.3, SD 0.2; P = 0.05. CT perfusion using an en bloc technique shows promise for the future evaluation of patients with critical limb ischemia and particularly for re-characterization post medical, surgical or endovascular intervention.

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Authors and Affiliations

  1. Medical Imaging, University Health Network, 399 Bathurst St., McLaughlin Pavilion, 3rd Floor Rm 431, Toronto, ON, M5T 2S8, Canada

    Joe Barfett & Nivethan Velauthapillai

  2. Medical Imaging, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada

    Christian Kloeters & Jeffrey D. Jaskolka

  3. Department of Neuroradiology, Toronto Western Hospital, 399 Bathurst St., Toronto, ON, Canada

    David J. Mikulis

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  1. Joe Barfett
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  2. Nivethan Velauthapillai
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  3. Christian Kloeters
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  4. David J. Mikulis
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  5. Jeffrey D. Jaskolka
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Correspondence to Joe Barfett.

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Barfett, J., Velauthapillai, N., Kloeters, C. et al. An en bloc approach to CT perfusion for the evaluation of limb ischemia. Int J Cardiovasc Imaging 28, 2073–2083 (2012). https://doi.org/10.1007/s10554-011-9978-z

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  • DOI: https://doi.org/10.1007/s10554-011-9978-z

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