期刊
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY
卷 41, 期 2, 页码 327-333出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RCT.0000000000000494
关键词
multidetector computed tomography angiography; digital subtraction angiography; peripheral arterial disease; stenosis; calcification
Objective: The aim of this study was to evaluate image quality and accuracy of 64+ detector multidetector computed tomography angiography (MDCTA) for hemodynamically significant (>= 50%) stenosis in patients with symptomatic peripheral arterial disease (PAD) using digital subtraction angiography as the reference standard. Methods: This is a retrospective study of 29 patients with PAD (19 men, 10 women) who underwent lower limb MDCTA (64- or 80-detector) and digital subtraction angiography. Image quality and accuracy of MDCTA for hemodynamically significant stenosis were assessed in the infrarenal aorta and 15 lower extremity segments. Results: Four hundred fifty-three segments were adequately visualized at both modalities. Multidetector CTA had 84.8% sensitivity, 87.7% specificity, and 86.3% accuracy for significant stenosis. Accuracy was decreased in the calf when compromising arterialwall calcifications were present versus absent (55.9% vs 82.4%, P < 0.0001). Conclusions: 64+ MDCTA is accurate in patients with symptomatic PAD. However, diagnostic accuracy in below-knee vessels remains relatively poorer. Alternative imaging modalities should be considered where below- knee disease is suspected.
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