AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ota, H.
Right arrow Articles by Takahashi, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ota, H.
Right arrow Articles by Takahashi, S.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Hotlight (NEW!)
Right arrow
What's Hotlight?

MDCT Compared with Digital Subtraction Angiography for Assessment of Lower Extremity Arterial Occlusive Disease: Importance of Reviewing Cross-Sectional Images

Hideki Ota1,2, Kei Takase1,2, Kazumasa Igarashi1, Yoshihiro Chiba1, Kenichi Haga1, Haruo Saito2 and Shoki Takahashi2

1 Department of Radiology, Ishinomaki Red Cross Hospital, 1-7-10 Yoshino, Ishinomaki, Miyagi 986-8522, Japan.
2 Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba, Sendai, Miyagi 980-8574, Japan.



View larger version (26K):

[in a new window]
  		Fig. 1. —Illustration shows iliac and lower extremity arterial segments. A = common iliac artery, B = external iliac artery, C = common femoral artery, D = superficial femoral artery, E = popliteal artery, F = tibioperoneal trunk, G = anterior tibial artery, H = posterior tibial artery, I = peroneal artery. A and B = iliac group, C and D = femoral group, and E–I = calf group.

 


View larger version (28K):

[in a new window]
  		Fig. 2. —Illustration shows tortuous artery. We drew vascular central line connecting centers of vascular lumina (arrows) using newly developed workstation and processed multiplanar reconstruction images (A–C) tangential to central line. A shows no luminal stenosis, B shows luminal stenosis, and C shows luminal stenosis with calcification.

 


View larger version (107K):

[in a new window]
  		Fig. 3A. —Illustrations show extents of mural calcification in arterial segments that are represented by classifications. Segment depicted is patent, so mural calcification would be described as "absent."

 


View larger version (86K):

[in a new window]
  		Fig. 3B. —Illustrations show extents of mural calcification in arterial segments that are represented by classifications. Segments depicted are examples of "mildly calcified," less than or equal to one half circumferential mural calcification (B), and "severely calcified," more than one half circumferential mural calcification (C).

 


View larger version (83K):

[in a new window]
  		Fig. 3C. —Illustrations show extents of mural calcification in arterial segments that are represented by classifications. Segments depicted are examples of "mildly calcified," less than or equal to one half circumferential mural calcification (B), and "severely calcified," more than one half circumferential mural calcification (C).

 


View larger version (187K):

[in a new window]
  		Fig. 4A. —77-year-old man with stenosis of iliac artery. Digital subtraction angiogram reveals severe stenosis (arrow) of left external iliac artery.

 


View larger version (119K):

[in a new window]
  		Fig. 4B. —77-year-old man with stenosis of iliac artery. Maximum-intensity-projection image shows severe stenosis (arrow) of left external iliac artery and mural calcification (arrowheads) of surrounding arteries. Arterial segment with mural calcification cannot be evaluated on this image.

 


View larger version (204K):

[in a new window]
  		Fig. 4C. —77-year-old man with stenosis of iliac artery. Volume-rendered image shows central line of left iliac artery connecting midpoints of cross-sectional vascular lumina. Three tangential lines—labeled D, E, and F— indicate levels corresponding to multiplanar reconstruction images (D–F).

 


View larger version (139K):

[in a new window]
  		Fig. 4D. —77-year-old man with stenosis of iliac artery. Cross-sectional multiplanar reconstruction image shows arterial patency with severe calcification immediately below level of aortic bifurcation (arrowhead) that maximum-intensity-projection image cannot depict. Degree of patency is consistent with that seen on digital subtraction angiography.

 


View larger version (119K):

[in a new window]
  		Fig. 4E. —77-year-old man with stenosis of iliac artery. Cross-sectional multiplanar reconstruction image shows severe stenosis (arrow) of external iliac artery.

 


View larger version (114K):

[in a new window]
  		Fig. 4F. —77-year-old man with stenosis of iliac artery. Cross-sectional multiplanar reconstruction image distal to level shown in E shows no stenosis (arrow) of external iliac artery.

 


View larger version (58K):

[in a new window]
  		Fig. 5A. —78-year-old man with stent in right iliac artery who underwent MDCT and digital subtraction angiography. and B, Digital subtraction angiogram (A) and maximum-intensity-projection image (B) both show short segment of severe stenosis in right superficial femoral artery (thin straight arrow), long segment of occlusion in left femoral artery (curved arrows), and occlusion of bilateral anterior tibial arteries (arrowheads). However, patency of stent-graft (thick straight arrow, A) is visualized only on angiogram; maximum-intensity-projection image does not provide any information concerning in-stent status (thick straight arrow, B). Review of cross-sectional images revealed in-stent patency.

 


View larger version (48K):

[in a new window]
  		Fig. 5B. —78-year-old man with stent in right iliac artery who underwent MDCT and digital subtraction angiography. Digital subtraction angiogram (A) and maximum-intensity-projection image (B) both show short segment of severe stenosis in right superficial femoral artery (thin straight arrow), long segment of occlusion in left femoral artery (curved arrows), and occlusion of bilateral anterior tibial arteries (arrowheads). However, patency of stent-graft (thick straight arrow, A) is visualized only on angiogram; maximum-intensity-projection image does not provide any information concerning in-stent status (thick straight arrow, B). Review of cross-sectional images revealed in-stent patency.

 


View larger version (149K):

[in a new window]
  		Fig. 6A. —69-year-old man with right iliac artery occlusion treated with stent-graft placement. Parasagittal multiplanar reconstruction image obtained with MDCT angiography shows complete occlusion (arrowheads) over 6-cm segment. This image was used to plan interventional radiology procedure.

 


View larger version (196K):

[in a new window]
  		Fig. 6B. —69-year-old man with right iliac artery occlusion treated with stent-graft placement. MDCT angiogram obtained early in placement procedure also shows occlusion of right iliac artery (arrows). Course of occluded segment seen in multiplanar reconstruction image (A) appears different from presumed course of same segment in this angiogram because of difference in angulation of images A and B.

 


View larger version (190K):

[in a new window]
  		Fig. 6C. —69-year-old man with right iliac artery occlusion treated with stent-graft placement. MDCT angiogram obtained at end of procedure shows revascularization of artery (arrows) after stent implantation.

 


View larger version (144K):

[in a new window]
  		Fig. 6D. —69-year-old man with right iliac artery occlusion treated with stent-graft placement. Curved planar reconstruction image obtained with follow-up MDCT angiography shows complete patency (arrow) of artery.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by the American Roentgen Ray Society.