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Type:
Educational Exhibit
Keywords:
Vascular, Extremities, CT-Angiography, Contrast agent-intravenous, Arteriosclerosis
Authors:
A. Casaleggio, C. Conforti, E. Fisci, R. Piccazzo, L. Bacigalupo, F. Paparo, G. A. Rollandi; Genoa/IT
DOI:
10.1594/ecr2015/C-0672
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 mm and more of table advancement for rotation) that improved spatial and temporal resolution allowing an optimal depiction of vessel anatomy and optimal detection of PAD [Brockmann].
The last metanalysis [Heijenbrok] showed a good diagnostic accuracy for MDCTA in detection of PAD,
compared to DSA,
with a pooled sensitivity for lower extremity arterial disease of 92% and a pooled specificity of 93%.
A recent study [Cernic] performed on 53 patients showed an overall sensitivity of 97.2%,
and an overall specificity of 93%.
In addition with the introduction of dual-energy scanners,
which use a different method of analysis of vessel calcification than the conventional calcification removal technique,
the evaluation of PAD has reached a better diagnostic accuracy,
especially regarding the specificity with values up to 97%.
Currently,
MDCTA is an effective method in the diagnosis of lower limb PAD and in our exhibit we describe our scanning acquisition technique in patients with PAD.