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Diagnostic value of time-resolved CT angiography for the lower leg

  • Computed Tomography
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Abstract

Objective

The aim of this study was to test the feasibility of time-resolved computed tomography angiography (TR-CTA) for use in the lower leg.

Methods

Fifty-nine patients with suspected peripheral arterial occlusive disease were examined with a standard CTA (S-CTA) of the lower run-off and with an additional TR-CTA of the calves (12 phases; 2.5 s/phase, 80 kV, 120 mAs, volume of contrast medium 50 mL, flow rate 5.0 mL/s). For seven lower-leg artery segments, arterial contrast and the presence of venous overlay were tested for S-CTA and TR-CTA. Stenoses were classified on a three-point scale separately for S-CTA and TR-CTA, and diagnostic confidence for stenosis assessment was evaluated for both datasets. Contrast arrival times and HU values were evaluated in patients with asymmetric proximal stenoses.

Results

TR-CTA resulted in significantly higher contrast enhancement (P < 0.0001) and less venous overlay as compared to S-CTA (P < 0.05). Diagnostic confidence for stenosis rating was significantly higher in TR-CTA (P < 0.0001). Asymmetric proximal stenoses lead to significantly delayed and diminished contrast enhancement on the stenotic side.

Conclusion

TR-CTA of the calves is feasible and provides higher enhancement and higher diagnostic confidence as compared to monophasic CTA of the lower legs.

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References

  1. Bui TD, Gelfand D, Whipple S, Wilson SE, Fujitani RM, Conroy R et al (2005) Comparison of CT and catheter arteriography for evaluation of peripheral arterial disease. Vasc Endovasc Surg 39:481–490

    Article  Google Scholar 

  2. Edwards AJ, Wells IP, Roobottom CA (2005) Multidetector row CT angiography of the lower limb arteries: a prospective comparison of volume-rendered techniques and intra-arterial digital subtraction angiography. Clin Radiol 60:85–95

    Article  CAS  PubMed  Google Scholar 

  3. Met R, Bipat S, Legemate DA, Reekers JA, Koelemay MJ (2009) Diagnostic performance of computed tomography angiography in peripheral arterial disease: a systematic review and meta-analysis. JAMA 301:415–424

    Article  CAS  PubMed  Google Scholar 

  4. Portugaller HR, Schoellnast H, Hausegger KA, Tiesenhausen K, Amann W, Berghold A (2004) Multislice spiral CT angiography in peripheral arterial occlusive disease: a valuable tool in detecting significant arterial lumen narrowing? Eur Radiol 14:1681–1687

    Article  PubMed  Google Scholar 

  5. Andreisek G, Pfammatter T, Goepfert K, Nanz D, Hervo P, Koppensteiner R et al (2007) Peripheral arteries in diabetic patients: standard bolus-chase and time-resolved MR angiography. Radiology 242:610–620

    Article  PubMed  Google Scholar 

  6. Meissner OA, Rieger J, Weber C, Siebert U, Steckmeier B, Reiser MF et al (2005) Critical limb ischemia: hybrid MR angiography compared with DSA. Radiology 235:308–318

    Article  PubMed  Google Scholar 

  7. Heijenbrok-Kal MH, Kock MC, Hunink MG (2007) Lower extremity arterial disease: multidetector CT angiography meta-analysis. Radiology 245:433–439

    Article  PubMed  Google Scholar 

  8. Sun Z (2006) Diagnostic accuracy of multislice CT angiography in peripheral arterial disease. J Vasc Interv Radiol 17:1915–1921

    Article  PubMed  Google Scholar 

  9. Mesurolle B, Qanadli SD, El Hajjam M, Goeau-Brissonniere OA, Mignon F, Lacombe P (2004) Occlusive arterial disease of abdominal aorta and lower extremities: comparison of helical CT angiography with transcatheter angiography. Clin Imaging 28:252–260

    Article  PubMed  Google Scholar 

  10. Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517

    Article  PubMed  Google Scholar 

  11. Fleischmann D, Hallett RL, Rubin GD (2006) CT angiography of peripheral arterial disease. J Vasc Interv Radiol 17:3–26

    Article  PubMed  Google Scholar 

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Correspondence to Wieland H. Sommer.

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Sommer, W.H., Helck, A., Bamberg, F. et al. Diagnostic value of time-resolved CT angiography for the lower leg. Eur Radiol 20, 2876–2881 (2010). https://doi.org/10.1007/s00330-010-1861-0

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  • DOI: https://doi.org/10.1007/s00330-010-1861-0

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