Abstract:
The purpose of this study was to compare the accuracy of
computed tomographic (CT) angiography with conventional digital
subtraction angiography as reference standard in the assessment of
aortoiliac and lower extremity arteries in patients with peripheral arterial
occlusive disease.
A total of 30 consecutive patients (21men with mean age of
60±11.5 years and 9 women with mean age of 59±14 years). The
patients underwent both conventional DSA and 16–detector row CT
angiography. For data analysis, the arterial vascular system was divided
into 35 segments. A total of 1050 arterial segments were analyzed for
arterial stenosis by two independent blinded readers using a four-point
grading system (grade 1, <10% luminal narrowing; grade 2, 10%–49%
luminal narrowing; grade 3, 50%–99% luminal narrowing; grade 4,
occlusion).
CT angiographic and conventional DSA findings were diagnostic
in all vascular segments. Compared with conventional DSA, the
sensitivity and specificity of 16–detector row CT angiography with
regard to detection of hemodynamically significant stenosis in all 35
arterial segments were 96.4% and 95.8%, respectively. CT reader
overestimated arterial stenosis in (3%) of arterial segments, and
underestimated arterial stenosis in (1%) of arterial segments. Presence of
anteroposteriorly located luminal narrowing and extensive vascular wall
calcification, were considered main reasons for disagreements between
imaging modalities.
Sixteen–detector row CT angiography is an accurate and reliable
noninvasive alternative to conventional DSA (with an accuracy of 96%)
in the assessment of aortoiliac and lower extremity arteries in patients
with peripheral arterial occlusive disease.
