Learning objectives
The purpose of our educational exhibit is:
To present our technique of multidetector computed tomography angiography (MDCTA) in a series of patients with peripheral artery disease (PAD),
using the “bolus test” (BT) technique
To optimize the acquisition delay obtaining homogeneous arterial contrast enhancement (CE),
without venous or parenchymal contamination
To describe normal arterious vessels anatomy of lower limb in MDCTA images
To show the findings obtained in patients with PAD
Background
Digital subtraction angiography (DSA) is the standard of care in the evaluation in patients with PAD; however it is an invasive procedure with a non-negligible risk of complications [Hessel].
For this reason non-invasive techniques such as MDCTA are increasingly used for the assessment of peripheral artery anatomy and PAD.
The improvement of MDCT technology resulted in computed tomography scanner of 64 detector rows and more,
enabling thin collimation (0.625mm and smaller section thickness),
fast scan speed (0.4 sec and lower of tube rotation time; 55...
Findings and procedure details
Procedure details
Technique of multidetector computed tomography angiography (MDCTA)
In our institution MDCTA are performed on a 64-slice scanner (LightSpeed VCT,
GE Healthcare,
Milwaukee,
USA).
Patients are placed in a supine position with their legs and their feet held together without tapes.
1. First of all it is necessary to talk to the patient and ask which leg hurts more and/or sooner when at rest and/or walking.
2. Anteroposterior and lateral scout images are then obtained from the dome of the diaphragm,
or from the...
Conclusion
Peripheral arterial disease (PAD) is a world-wide problem affecting predominantly elderly patients [Aronow],
who has known,
have a progressive decrease in arterial blood flow [Masugata].
Because of fast scanning allowed by the current 64-slice and higher MDCT devices the exact assessment of the delay needed by the contrast media to reach the feet is critical to correctly plan and acquire MDCTA of PAD.
Our MDCTA technique in PAD is feasible in routine and emergency allowing optimal assessment of wall irregularities,
stenosis/obstruction and any collateral vessels....
Personal information
Alessandro Casaleggio,
Cristina Conforti,
Erica Fisci
MD,
Radiology residents of the University of Genoa,
Italy.
Riccardo Piccazzo,
Lorenzo Bacigalupo,
Francesco Paparo
MD,
Radiologists,
E.O.
Ospedali Galliera,
Genoa,
Italy.
Gian Andrea Rollandi
MD,
Radiologist,
Director Radiology,
E.O.
Ospedali Galliera,
Genoa,
Italy.
References
1.Hessel SJ,
Adams DF,
Abrams HL.
Complications of angiography.
Radiology 1981;138: 273–281.
2. Brockmann C.,
Jochum S.,
Sadick M.
Dual-Energy CT Angiography in Peripheral Arterial Occlusive Disease.
Cardiovasc Intervent Radiol (2009) 32:630–637
3. Heijenbrok-Kal MH1,
Kock MC,
Hunink MG.
Lower extremity arterial disease: multidetector CT angiography meta-analysis.
Radiology.
2007 Nov;245(2):433-9.
4. Aronow WS: Peripheral arterial disease in the elderly.
Clinical Intervent Aging.
2007;2:645–54.
5.Masugata H,
Senda S,
Goda F et al.:A new index of ‘‘cardiac age’’ derived from echocardiography: influence of hypertension and comparison with...