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Vascular and Interventional Radiology |
1 From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, Rm S-072B, Stanford, CA 94305-5105. Received July 27, 2000; revision requested September 8; revision received March 15, 2001; accepted April 3. Supported by NIH grant R01HL58915. Address correspondence to G.D.R. (e-mail: grubin@stanford.edu).
PURPOSE: To assess the patterns of lower extremity arterial inflow and runoff opacification with four-channel multidetector row computed tomographic (CT) angiography in a cohort of patients with disease warranting imaging of the lower extremity arterial system.
MATERIALS AND METHODS: Twenty-four patients with symptomatic lower extremity arterial occlusive or aneurysmal disease underwent imaging with four-channel multidetector row CT from the supraceliac abdominal aorta through the feet. Transverse sections were acquired with a 2.5-mm nominal detector width and pitch of 6.0 (3.2-mm effective section thickness) following intravenous injection of 174185 mL of iodinated contrast medium (300 mg iodine per milliliter). In each patient, attenuation measurements were recorded in 16 arterial and 16 venous locations. In 18 patients, two radiologists assessed the detectability and stenosis degree of 21 arterial segments per patient relative to these features at conventional angiography.
RESULTS: A mean scannning time of 66 seconds was required to cover a mean of 1,233 mm, resulting in a mean of 908 transverse reconstructions. All 504 arterial segments were depicted and analyzable. Mean arterial attenuation ranged from 253 HU in the midabdominal aorta to 357 HU in the popliteal artery and 253 HU in the dorsalis pedis or posterior tibial artery measured inferior to the tibiotalar joint. Maximum mean venous enhancement (99 HU) was observed in the saphenous vein at the ankle, with all other venous stations measuring less than 74 HU.
CONCLUSION: The arteries of lower extremity inflow and runoff can be reliably depicted with minimal venous enhancement by using multidetector row CT.
Index terms: Arteries, CT, 92.12912. 92.12915, 92.12916, 92.12917 Arteries, extremities, 92.72, 92.73 Computed tomography (CT), angiography, 92.12916
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