Richard Lee Hallett MD, Presenter: Nothing to Disclose

1) Describe techniques for patient selection, acquisition, reconstruction, and interpretation of lower extremity CTA. 2) Describe evidence-based results for lower extremity CTA, and expected impact on patient care. 3) Describe a coherent plan that integrates lower extremity CTA into cost-effective clinical care.

Peripheral arterial disease (PAD) is a common cause of morbidity and mortality in developed countries. Traditionally, imaging for risk stratification and therapeutic planning involved catheter angiography. In recent years, cross-sectional imaging by CTA and MRA has proven a robust technique for non-invasive PAD assessment. Given ubiquity of CT scanning technology, CTA is widely available. High resolution datasets can be acquired rapidly, which facilitates assessment of clinically labile or trauma patients. To be optimally effective, CTA techniques require particular attention to contrast medium and scan protocol. With appropriate protocol design, data acquisition requires limited operator dependence. The acquired 3D dataset is rich with information, but requires careful scrutiny by the interpreting physician. Volumetric review of these datasets produces the most accurate results. Extensive small vessel calcification remains a potential barrier to full assessment of pedal vessels by CTA. Recent published data validates the clinical effectiveness of CTA for diagnosis of PAD and for the direction of treatment planning. Ongoing research aims to exploit the newest generation of CT scanners to acquire additional information, including dual energy data, time-resolved information, and radiation dose savings.  

www://stanford.edu/~hallett

http://media.rsna.org/media/abstract/2014/13012018/RC212B sec.pdf

Hallett, R, Lower Extremity CTA.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13012018.html