| Diagnostic accuracy of 64 multidetector computed tomographic angiography in peripheral vascular disease. | |
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MedLine Citation:
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PMID: 19753637 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. OBJECTIVE: The purpose of this study was to evaluate the diagnostic accuracy of 64 MDCT for the detection of hemodynamically significant disease within the lower extremity peripheral vasculature as compared to digital subtraction angiography (DSA). METHODs: Twenty-eight consecutive patients with symptomatic lower extremity intermittent claudication and an abnormal ankle-brachial index (ABI; less than 0.9) were evaluated by both 64 MDCT and DSA. Axial images were acquired with a 64 multidetector general electric light speed VCT scanner. Images were analyzed using a GE Advantage workstation (AW 4.3) capable of advanced image processing and manipulation. The aorto-iliac and lower extremity arteries were divided into 15 segments per limb (30 segments per patient). Eight hundred forty segments were analyzed in a blinded fashion by physicians with level III CT certification. Segments were classified as grade I (<10% stenosis), grade II (10-49%), grade III (50-99%), and grade IV (occlusion). Results: For all segments evaluated, the overall diagnostic accuracy for detecting grade III and IV lesions was 98% with a sensitivity of 99% and a specificity of 98%. For the aorto-iliac segments, the diagnostic accuracy was 98% with a sensitivity of 100% and a specificity of 99%. For the femoro-popliteal segments, the overall accuracy was 98% with a sensitivity of 100% and a specificity of 99%. For the infra-popliteal segments, the overall accuracy was 98% with a sensitivity of 97% and a specificity of 99%. One segment could not be visualized by MDCT compared to 49 segments that could not be visualized by DSA. CONCLUSIONS: This study demonstrates excellent diagnostic accuracy of 64 MDCT in the detection of hemodynamically significant disease of the lower extremities. More segments are visualized using 64 MDCT than DSA, allowing more complete visualization of the vascular tree. CT angiography should be considered in the diagnostic evaluation of symptomatic patients with peripheral vascular disease. |
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Authors:
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Shahrzad Shareghi; Ambarish Gopal; Khawar Gul; James C Matchinson; Christopher B Wong; Nicole Weinberg; Mark Lensky; Matthew J Budoff; David M Shavelle |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 75 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-23 Completed Date: 2010-03-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 23-31 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Wiley-Liss, Inc. |
Affiliation:
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Division of Cardiology, Harbor-UCLA Medical Center, Torrance, California 90509, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiography, Digital Subtraction* Ankle / blood supply Arterial Occlusive Diseases / complications, physiopathology, radiography* Blood Pressure Brachial Artery / physiopathology Constriction, Pathologic Female Humans Intermittent Claudication / etiology, physiopathology, radiography* Lower Extremity / blood supply* Male Middle Aged Predictive Value of Tests Prospective Studies Radiographic Image Interpretation, Computer-Assisted Sensitivity and Specificity Severity of Illness Index Tomography, X-Ray Computed* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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