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Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia

Received: 17 July 2014     Accepted: 3 August 2014     Published: 30 September 2014
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Abstract

Objective: To evaluate the value of MDCT Angiography in imaging the arterial tree of the lower limbs in peripheral vascular disease. Back-ground: Peripheral arterial disease (PAD) is defined as any pathologic process causing obstruction to blood flow in the arteries, exclusive of the coronary and cerebral vascular beds. Conventional angiography is associated with 1-2% rate of complications and requires highly skilled physician to perform it. Non-invasive imaging modalities include duplex ultrasonography, magnetic resonance angiography (MRA), and multi-detector computed tomography angiography (MDCTA). Methods: This study includes 30 patients of variable ages, complaining from peripheral arterial disease manifestations referred to the radiology department of Menoufia University hospital. All patients underwent multi-detector row CT angiography of the lower limbs arteries. The findings were then analyzed and retrospectively compared with the surgical outcome in cases of operative intervention or Color Doppler correlation. Results: 120 lesions were detected in which 12 lesions (10%) were noted at the aortoiliac vessels, 33 lesions (27.5%) were noted at the femoropopliteal vessels in and 75 lesions (62.5%) were noted at the infrapopliteal vessels. No statistically significant difference between Doppler and CT angiography regarding all the anatomic segments of the arterial tree. Conclusion: Multi-detector CT angiography has demonstrated its efficacy as a promising new, fast, accurate, safe and a minimally-invasive imaging modality in cases of trauma with suspected arterial injuries and in cases of peripheral vascular diseases for diagnosis, grading and for preoperative evaluation. It can also replace color Doppler ultrasonography in many cases.

Published in International Journal of Medical Imaging (Volume 2, Issue 5)
DOI 10.11648/j.ijmi.20140205.16
Page(s) 125-130
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Peripheral Arterial Disease, MDCTA, Duplex Ultrasonography

References
[1] Kasapis C , Gurm HS: Current Approach to the Diagnosis and Treatment of Femoral Popliteal Arterial Disease. A Systematic Review.Curr Cardiol Rev 2009; 5(4): 296–311.
[2] Collins R, Burch J, Cranny G , Westwood M: Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic lower limb peripheral arterial disease. A Systematic Review. BMJ 2007; 334:1257.
[3] Met R, Bipat S, Legemate DA , Koelemay MJ: Diagnostic Performance of Computed Tomography Angiography in Peripheral Arterial Disease .A Systematic Review and Meta-analysis . JAMA 2009; 301(4):415-424.
[4] Laswed T, Rizzo E, Guntern D , Qanadli SD:Assessment of occlusive arterial disease of abdominal aorta and lower extremities arteries: value of multidetector CT angiography using an adaptive acquisition method Eur Radiol 2008; 18(2):263-272.
[5] Gouny P ,Verhaeghe A, Nonent M, Gueret G , Badra A: Multi-Detector Row Computed Tomography Angiography : an Alternative Imaging Method for Surgical Strategy in Lower Extremity Arterial Occlusive Disease. ActaChirBelg, 2005; 105:592-601.
[6] Foley WD , Stonely T: CT angiography of the lower extremities. RadiolClin North Am Mar 2010; 48(2):367-96.
[7] Fleischmann D, Hallett RL , Rubin GD: CT angiography of peripheral arterial disease. J VascIntervenRadiol 2006; 17(1): 3–26.
[8] Rubin GD, Shiau MC, Leung AN, Kee ST, Logan LJ , Sofilos MC: Aorta and iliac arteries: single versus multiple detector-row helical CT angiography. Radiology Jun 2000; 215(3): 670–6.
[9] Ofer A, Nitecki SS, Linn S, Epelman M, Fischer D, Karram T, Litmanovich D, Schwartz H, Hoffman A, Engel A:Multidetector CT angiography of peripheral vascular disease: A prospective comparison with intra-arterial digital subtraction angiography. AJR 2003; 180: 719-724.
[10] Willmann JK, Mayer D, Banyai M: Evaluation of peripheral arterial bypass grafts with multi-detector row CT angiography: comparison with duplex US and digital subtraction angiography. Radiology Nov 2003; 229(2): 465–74.
[11] Ozkan U, Oguzkurt L , Tercan F: Atherosclerotic risk factors and segmental distribution in symptomatic peripheral artery disease. J VascIntervRadiol Apr 2009; 20(4):437-41.
Cite This Article
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    Maged Abdelfattah Ali Algazzar, Mohamed Salah Eldin Elzawawi, Khaled El-Sayed Alhawary, Waleed AbdelFattah Mousa. (2014). Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia. International Journal of Medical Imaging, 2(5), 125-130. https://doi.org/10.11648/j.ijmi.20140205.16

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    ACS Style

    Maged Abdelfattah Ali Algazzar; Mohamed Salah Eldin Elzawawi; Khaled El-Sayed Alhawary; Waleed AbdelFattah Mousa. Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia. Int. J. Med. Imaging 2014, 2(5), 125-130. doi: 10.11648/j.ijmi.20140205.16

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    AMA Style

    Maged Abdelfattah Ali Algazzar, Mohamed Salah Eldin Elzawawi, Khaled El-Sayed Alhawary, Waleed AbdelFattah Mousa. Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia. Int J Med Imaging. 2014;2(5):125-130. doi: 10.11648/j.ijmi.20140205.16

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  • @article{10.11648/j.ijmi.20140205.16,
      author = {Maged Abdelfattah Ali Algazzar and Mohamed Salah Eldin Elzawawi and Khaled El-Sayed Alhawary and Waleed AbdelFattah Mousa},
      title = {Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia},
      journal = {International Journal of Medical Imaging},
      volume = {2},
      number = {5},
      pages = {125-130},
      doi = {10.11648/j.ijmi.20140205.16},
      url = {https://doi.org/10.11648/j.ijmi.20140205.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20140205.16},
      abstract = {Objective: To evaluate the value of MDCT Angiography in imaging the arterial tree of the lower limbs in peripheral vascular disease. Back-ground: Peripheral arterial disease (PAD) is defined as any pathologic process causing obstruction to blood flow in the arteries, exclusive of the coronary and cerebral vascular beds. Conventional angiography is associated with 1-2% rate of complications and requires highly skilled physician to perform it. Non-invasive imaging modalities include duplex ultrasonography, magnetic resonance angiography (MRA), and multi-detector computed tomography angiography (MDCTA). Methods: This study includes 30 patients of variable ages, complaining from peripheral arterial disease manifestations referred to the radiology department of Menoufia University hospital. All patients underwent multi-detector row CT angiography of the lower limbs arteries. The findings were then analyzed and retrospectively compared with the surgical outcome in cases of operative intervention or Color Doppler correlation. Results: 120 lesions were detected in which 12 lesions (10%) were noted at the aortoiliac vessels, 33 lesions (27.5%) were noted at the femoropopliteal vessels in and 75 lesions (62.5%) were noted at the infrapopliteal vessels. No statistically significant difference between Doppler and CT angiography regarding all the anatomic segments of the arterial tree. Conclusion: Multi-detector CT angiography has demonstrated its efficacy as a promising new, fast, accurate, safe and a minimally-invasive imaging modality in cases of trauma with suspected arterial injuries and in cases of peripheral vascular diseases for diagnosis, grading and for preoperative evaluation. It can also replace color Doppler ultrasonography in many cases.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Role of Multi-Detector Computed Tomography Angiography in the Evaluation of Lower Limb Ischemia
    AU  - Maged Abdelfattah Ali Algazzar
    AU  - Mohamed Salah Eldin Elzawawi
    AU  - Khaled El-Sayed Alhawary
    AU  - Waleed AbdelFattah Mousa
    Y1  - 2014/09/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ijmi.20140205.16
    DO  - 10.11648/j.ijmi.20140205.16
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 125
    EP  - 130
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20140205.16
    AB  - Objective: To evaluate the value of MDCT Angiography in imaging the arterial tree of the lower limbs in peripheral vascular disease. Back-ground: Peripheral arterial disease (PAD) is defined as any pathologic process causing obstruction to blood flow in the arteries, exclusive of the coronary and cerebral vascular beds. Conventional angiography is associated with 1-2% rate of complications and requires highly skilled physician to perform it. Non-invasive imaging modalities include duplex ultrasonography, magnetic resonance angiography (MRA), and multi-detector computed tomography angiography (MDCTA). Methods: This study includes 30 patients of variable ages, complaining from peripheral arterial disease manifestations referred to the radiology department of Menoufia University hospital. All patients underwent multi-detector row CT angiography of the lower limbs arteries. The findings were then analyzed and retrospectively compared with the surgical outcome in cases of operative intervention or Color Doppler correlation. Results: 120 lesions were detected in which 12 lesions (10%) were noted at the aortoiliac vessels, 33 lesions (27.5%) were noted at the femoropopliteal vessels in and 75 lesions (62.5%) were noted at the infrapopliteal vessels. No statistically significant difference between Doppler and CT angiography regarding all the anatomic segments of the arterial tree. Conclusion: Multi-detector CT angiography has demonstrated its efficacy as a promising new, fast, accurate, safe and a minimally-invasive imaging modality in cases of trauma with suspected arterial injuries and in cases of peripheral vascular diseases for diagnosis, grading and for preoperative evaluation. It can also replace color Doppler ultrasonography in many cases.
    VL  - 2
    IS  - 5
    ER  - 

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Author Information
  • Radiology department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

  • Radiology department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

  • Radiology department, National Liver Institute, Menoufia University, Menoufia, Egypt

  • Radiology department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

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