DOI:10.2214/AJR.06.5033
AJR 2006; 186:E7
© American Roentgen Ray Society
Evaluation of the Radial Artery
Musturay Karcaaltincaba and
O. Faruk Dogan
Hacettepe University School of Medicine Sihhiye Ankara, 06100
Turkey
We read the study of Dr. Feuchtner et al.
[1] with great interest. The
study showed the usefulness of 16-MDCT angiography for evaluation of the
radial artery prior to coronary artery bypass grafting procedures.
We also published our experience with 4-MDCT on 16 patients in January 2005
[2]. We have been using this
technique since 2003 for the preoperative evaluation of radial arteries. We
used 4 x 1 mm collimation; pitch, 1.75; gantry rotation time, 0.5 sec;
and table speed, 1.4 cm/sec. We currently use 16-MDCT for this purpose and so
far have scanned 10 patients. Our protocol uses 16 x 0.75 mm
collimation; pitch, 1.5; gantry rotation time, 0.5 sec; and table speed, 3.5
cm/sec. In both scanners, we inject 300 mg/mL of iodinated contrast material
with an injection rate of 4-5mL/sec. We prefer not to use a fixed delay
because most patients have cardiac disease and cardiac output may vary
significantly. With this method, we detect the arrival of contrast material to
the brachial artery in real time using bolus tracking and start the
acquisition manually [3]. After
using 16-MDCT, we reduced contrast dose from 120 mL (with 4-MDCT) to 80-100 mL
(with 16-MDCT). Apart from slightly better visualization of palmar arteries,
we could not detect a significant difference between the image quality of 4-
and 16-MDCT.
The major advantages of MDCT angiography are its noninvasiveness and its
ability to detect calcific plaque, which can be difficult to diagnose by
conventional angiography.
Radial artery MDCT angiography has become a standard procedure in our
institution for preoperative evaluation for a potential bypass graft. Although
16-MDCT is preferred for this purpose, 4-MDCT can provide satisfactory
images.
References
- Feuchtner GM, Smekal A, Friedrich GJ, et al. High-resolution
16-MDCT evaluation of radial artery for potential use as coronary artery
bypass graft: a feasibility study. AJR2005; 185:1289
-1293[Abstract/Free Full Text]
- Dogan OF, Karcaaltincaba M, Duman U, et al. Assessment of the
radial artery and hand circulation by computed tomography angiography: a pilot
study. Heart Surg Forum 2005;8
: E28-E33[Medline]
- Karcaaltincaba M, Akata D, Leblebicioglu G, et al. MDCT angiography
of the extremities in pediatric patients: initial experience.
AJR 2004; 183:189
-192[Abstract/Free Full Text]
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