Thomas Albrecht MD, Presenter: Nothing to Disclose

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

Constanze Ribbe, Abstract Co-Author: Nothing to Disclose

Karl Juergen Wolf MD, Abstract Co-Author: Nothing to Disclose

To compare 16-slice multidetector-CTA and DSA in peripheral arteriography of the pelvis, leg and foot.

CTA of peripheral arteries was performed in 28 patients using a Somatom Sensation 16 (Siemens, Germany). Collimation was 16 x 1.5 mm, rotation time 0.5 s, table feed 40mm/sec, slice thickness 2 mm, reconstruction interval 1.2 mm. 100 ml Iomeprol 400 (Bracco, Italy) were injected at 4 ml/s followed by 50 ml saline. Bolus tracking was used. DSA was performed within 4 weeks of CTA using 4F pigtail catheter and approx. 180 ml Iomeprol 300. CTA and DSA were independently read by blinded readers based on arterial segments (maximum of 25 per patient). Stenoses were classified on a 4 grade scale (I: < 50%, II: 50-75%, III: 76-99%, IV: occlusion).

A total of 436 vascular segments were analysed (several patients had only limited periinterventional DSA). 12 of these were not visualised on CTA (all below knee) and 28 segments were not seen on DSA (3 above and 25 below knee). A total of 446 stenoses/occlusions were seen on both modalities. Grading of these showed complete agreement between CTA and DSA in 77.4%, overestimation by CTA of 1° in 12.6%, underestimation (CTA) of 1° in 9.0%, overestimation (CTA) of > 1° in 0.7% and underestimation (CTA) > 1° in 0.4%. Compared to DSA as gold standard, sensitivity and specificity of CTA for detecting high grade stenoses (>75%) and occlusions was 91% and 96% respectively. Agreement between CTA and DSA was excellent (kappa: 0.89).

There was excellent agreement between CTA and DSA with regards to grading of stenoses with complete agreement in 77.4% of patients. Discrepancies of more than 1 grade occurred in only 1% of stenoses. CTA proved more sensitive than DSA in demonstrating small peripheral arteries with poor contrast filling.

Albrecht, T, Meyer, B, Ribbe, C, Wolf, K, 16-slice MD-CTA versus Digital Subtraction Angiography in the Assessment of Peripheral Arteries.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4413903.html