Jürgen Karl Willmann MD, Abstract Co-Author: Nothing to Disclose

Bernhard Baumert MD, Abstract Co-Author: Nothing to Disclose

Thomas Schertler MD, Abstract Co-Author: Nothing to Disclose

Simon Wildermuth MD, Presenter: Nothing to Disclose

Thomas Pfammatter MD, Abstract Co-Author: Nothing to Disclose

Borut Marincek MD, Abstract Co-Author: Nothing to Disclose

Thomas Boehm MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To compare sixteen-row computed tomography angiography (CTA) with catheter digital subtraction angiography (DSA) for assessing the aortoiliac and lower extremity arteries in patients with peripheral arterial disease (PAD).

Thirty-nine consecutive patients with PAD (27 men, 12 women; mean age, 65 years; age range, 44-81 years) who underwent catheter DSA for clinical reason were reexamined with sixteen-row CTA (Somatom Sensation 16, Siemens; collimation, 16 x 0.75mm; table-feed, 18 mm/rotation (pitch, 1.5); slice-width, 0.75 mm; reconstruction increment, 0.4 mm; contrast media, 100 mL; flow rate, 4 mL/sec) within 1 week. Two independent blinded readers assessed the CT data sets, a third reader evaluated the DSA images. All reviewers were unaware of the results of the other imaging modality. For data analysis, the arterial vascular system was divided into 35 arterial segments and catheter DSA was used as the standard of reference. A total of 1365 arterial segments were analyzed for arterial stenosis using a 4-point grading system (1, < 10% luminal narrowing; 2, < 50% luminal narrowing; 3, 50%-99% luminal narrowing; 4, occlusion).

Sixteen-row CTA was diagnostic for all 1365 vascular segments. Compared to DSA, the total sensitivity and specificity of sixteen-row CTA with regard to detection of hemodynamically significant stenosis (> 50% luminal narrowing) were 96% (95% CI, 94%,98%) and 97% (95% CI, 96%,98%) for reader 1 and 97% (95% CI, 95%,99%) and 97% (95% CI, 96%,98%) for reader 2. Reader 1 and 2 overestimated arterial stenosis in 42 (3%) and 34 (2.5%) arterial segments, respectively and underestimated vascular stenosis in 13 (1%) and 10 (0.7%) arterial segments, respectively. Interobserver agreement was excellent for all degrees of arterial stenosis (κ = 0.89; 95% CI, 0.87,0.91), for determination of hemodynamically insignificant versus significant arterial stenosis (κ = 0.93; 95% CI, 0.91,0.95) and for diagnosing non-occlusion versus occlusion (κ = 0.97; 95% CI, 0.95,0.99).

Sixteen-row CTA is an accurate and reliable, non-invasive alternative to catheter DSA for assessing the aortoiliac and lower extremity arteries in patients with PAD.

Willmann, J, Baumert, B, Schertler, T, Wildermuth, S, Pfammatter, T, Marincek, B, Boehm, T, et al, , Sixteen-Row CT Angiography for Assessment of the Aortoiliac and Lower Extremity Arteries in Patients with Peripheral Arterial Disease: Prospective Comparison with Digital Subtraction Angiography.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409642.html