Multi-slice spiral CT: 3D CT angiography for evaluating therapeutically relevant stenosis in peripheral arterial occlusive disease

PURPOSE: Evaluation of 3D multislice CT angiography for the assessment of relevant stenoses of pelvic arteries and arteries of the lower extremity in patients with peripheral artery occlusive disease compared to digital subtraction angiography. METHOD/MATERIALS: For this study we examined 31 patients with peripheral artery occlusive disease. All patients received a multislice helical CT angiography and arterial digital subtraction angiography. Multislice CT angiography was performed with a Somatom Plus 4 Volume Zoom (Siemens, Erlangen, Germany). After test bolus injection of 20 ml Ultravist 370 (Schering AG, Berlin) additional 150 ml were applied with a flow rate of 3 ml/sec and a scan delay between 20-35 sec depending on individual blood circulation time. Collimation was 4 x 2.5 mm with a pitch of 6. Reconstructed slice thickness was 3 mm. 3D reconstructions of arteries of pelvic and lower extremity arteries were performed in volume rendering technique on a 3D Virtuoso workstation (Siemens, Erlangen). RESULTS: For the assessment of therapeutically relevant stenoses (over 50% reduction of luminal diameter) multislice CT achieved the following results compared to conventional angiography for the diagnosis of stenosis: sensitivity of 86%, specificity of 86% and an accuracy of 72%. CONCLUSIONS: Multislice helical CT angiography of pelvic arteries and arteries of the thigh represents a reliable means for the detection of relevant stenoses in patients with peripheral occlusive artery disease.