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

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.