MDCTA finding of lower limb in diabetes patient

Abstract

This study was a descriptive study type designed to evaluate the efficacy of multislice computerized tomography (MSCT) in imaging the lower limb arterial tree to diagnose the ischemic and other vascular disease in diabetes patient, the data was collected from radiology department of ROYAL CARE INTERNATIONAL HOSPITAL, AL ALMAL NATIONAL HOSPITAL, the study was carried out in the (Sudan–Khartoum state). The study duration from March 2014 to February 2015: the patient population consists of 18 females and 22 males with the mean of the ages is 64y and the male percent 55% was more than females 45.0 %. In the study the disease prolongation categorized as (>1 y, 1-5y, and <5 y and percent7.5%, 85.0%, 7.5% and the common finding was Atherosclerosis ,total , stenosis, occlusion and collateral. 40 diabetes patient s have undergone CT angiography of the lower limb by Multidetector (Toshiba Aquilion 64 CT Scanner ) . with symptoms of peripheral vascular disease, All patients were scanned in the supine position with A detector configuration of 64 x 0.5 mm is used, and 0.5 mm thick sections are reconstructed at 0.3 mm intervals, acquisition timing for optimum opacity is achieved by using automatic bolus tracking (Sure Start technology, Toshiba Medical Systems), with 135-140 cc of low osmolar non-ionic contrast medium (Omnipaque 300) with a flow rate between 5-6 cc/sec, via a pressure injector ,by using tow boxes of the scan protocol 52.5 % to excluded the false positive and one box scan protocol 47.5 % . Axial images were then reconstructed with 50 percent overlap and then transferred to a dedicated workstation for 3-D reconstruction and analysis; in maximum intensity projection (MIP), volume rendered (VR) and (MPR), the correlation between CTA finding and Contrast Media Flow Rate were insignificant at the p value 0.483, the Rt side is more affected , A correlation between CTA finding and Size of lesion, total occlusion and collateral the percent 42.5%, Atherosclerosis and stenosis the percent 27.5% there were an association at the P value 0.000, and the most common used technique is the MIP and VRT 65% were significant at the p value 0.005, the Crosstab between C.M flow rate and scan protocol significant study at the P value 0.000, the Crosstab between C.M flow rate and scan protocol significant study at the P value 0.000. Our initial experience CT angiography with multislice has clearly demonstrate efficacy as a promising new, fast, accurate, safe and non-invasive imaging modality of choice in cases of diabetes peripheral vascular diseases for diagnosis, for grading, for potential usefulness and as a treatment planning tool and are the key to communicating the findings to the treating physician, decisions making (surgical versus transluminal revascularization, or, intervention, conservative treatment).