Introduction
Technique
Preparation
Parameter | Description |
---|---|
Clothing | No metal parts on clothing |
Oral contrast | None |
I.V. cannula antecubital | Minimally 22 G (0.6 mm inner diameter, blue valve) |
Positioning | Supine, stabilized and lightly strapped, feet-first and arms elevated |
Respiratory phase | Inspiration during abdominal-pelvic range |
Technical parameters
Scan duration
Type of scanner | Section collimation width (mm)b
| Rotation time (s) | Pitchc
| Table feed (mm/ rotation) | Table speed (mm/s) | Scan duration (s) d
| Characteristics |
---|---|---|---|---|---|---|---|
4D-CTa
| 4 × 2.5 | 0.5 | 1.5 | 15 | 30 | 40 | Slow scan protocol, thick minimal slice width |
16D-CTa
| 16 × 0.75 | 0.5 | 1.3 | 15 | 30 | 40 | Slow scan protocol, high resolution |
16 × 1.5 | 0.5 | 0.7 | 17 | 34 | 35 | Slow scan protocol, less resolution, better in obese patients | |
16 × 1.5 | 0.5 | 1.0 | 24 | 48 | 25 | Fast scan protocol, less resolution, reduction of contrast media | |
64D-CTa
| 2 × 32 × 0.6 | 0.5 | 0.8 | 15 | 30 | 40 | Slow scan protocol, high resolution, isotropic voxel, double z-sampling, scanning of obese patients possible |
2 × 32 × 0.6 | 0.33 | 0.8 | 16 | 48 | 25 | Fast scan protocol, reduction of contrast media, high resolution, isotropic voxel, double z-sampling, scanning of obese patients possible | |
2 × 32 × 0.6 | 0.33 | 1.0 | 19.8 | 60 | 20 | Fast scan protocol, reduction of contrast media, high resolution, isotropic voxel, double z-sampling, scanning of obese patients possible, risk of outrunning the bolus |
Collimation
Contrast injection
Acquisition timing
Contrast injection
Patient dose in MDCT
Display and evaluation
Image reconstruction
Advanced postprocessing and image evaluation
Wall calcification problem
Clinical value
Authora
| No. of patients | No. of analyzed segments | No. of detectors | Reported sensitivity (%)e
| Reported specificity (%)e
| Assessed segments | Stenosis category (%)h
|
---|---|---|---|---|---|---|---|
Richter et al. 1994 | 32 | ns | 1 | 84 | ns | Iliac | >50 |
Lawrence et al. 1995 | 6 | 134 | 1 | 93 | 96 | Femorocrural | >50 |
Raptopoulos et al. 1996 | 39 | 624 | 1 | 93 | 96 | Aortoiliac | 85–99 |
Rieker et al. 1996 | 50 | 400 | 1 | 73–88b
| 94–100b
| Femorocrural | 75–99 |
Rieker et al. 1997 | 30 | 210 | 1 | 93 | 99 | Aortoiliac | 75–99 |
Kramer et al. 1998 | 10 | ns | 2 | 94 | ns | Iliocrural | >90–99 |
Ishikawa et al. 1999 | 49 | ns | 1 | 97 | 95 | Bypass grafts | ns |
Bourlet et al. 2000 | 22 | 318 | 1 | 95 | 90 | Aortoiliac | >50 |
Puls et al. 2001 | 31 | 186 | 4 | 89 | 86 | Total tree | 50–99 |
Willman et al. 2003 | 46 | 769 | 4 | 91 | 99 | Aortoiliac grafts | ns |
Ofer et al. 2003 | 18 | 410 | 4 | 91 | 92 | Total tree | >50 |
Heuschmid et al. 2003 | 18 | 568 | 4 | 91c
| 92c
| Total tree | >50 |
Martin et al. 2003 | 41 | 1,312 | 4 | 92 | 97 | Total tree | 75–99 |
Catalano et al. 2004 | 50 | 1,148 | 4 | 96 | 93 | Total tree | >50 |
Mesurolle et al. 2004 | 16 | 168 | 2 | 91 | 93 | Total tree | >50 |
Ota et al. 2004 | 24 | 470 | 4 | 99 | 99 | Total tree | >50 |
Poletti et al. 2004d
| 12 | 144 | 4 | 82/96g
| ns | ns | >50 |
Portugaller et al. 2004 | 50 | 740 | 4 | 92 | 83 | Total tree | area >70 |
Romano et al. 2004 | 42 | 3,402 | 4 | 93 | 95 | Total tree | ns |
Romano et al. 2004 | 22 | 1,782 | 4 | 92 | 94 | Total tree | ns |
Stueckle et al. 2004 | 52 | ns | 4 | 82 | 100 | Total tree | ns |
Edwards et al. 2005 | 44 | 1,024 | 4 | 79 | 93 | Total tree | 50–99 |
Fraioli et al. 2006 | 75 | 1,425 | 4 | 96–99h
| 94–96h
| Total tree | 50–99 |
Schertler et al. 2005 | 17 | 170 | 16 | 96 | 90 | Popliteocrural | >50 |
Willmann et al. 2005 | 39 | 1,365 | 16 | 96 | 96 | Total tree | >50 |
Unpooled mean | 91 | 94 |
Authora
| No. of patients | No. of assessed segments | No. of detectors | Reported intertest agreementd
| Assessed segments |
---|---|---|---|---|---|
Raptopoulos et al. 1996 | 39 | 624 | 1 | 90% | Aortoiliac |
Beregi et al. 1997 | 20 | 52 | 1 | 100% | Popliteal |
Tins et al. 2001 | 35 | 219 | 1 | 84% | Aortoiliac |
Walter et al. 2001 | 22 | 456 | 4 | κ = 0.68 (0.50–0.97)c
| Total tree |
Rubin et al. 2001 | 18 | 351 | 4 | 100% | Total tree |
Heuschmid et al. 2003 | 23 | 1,136 | 4 | 86% | Total tree |
Ofer et al. 2003 | 18 | 444 | 4 | 78% | Total tree |
Romano et al. 2004 | 42 | 3,402 | 4 | κ = 0.68; 90% | Total tree |
Romano et al. 2004 | 22 | 1,782 | 4 | κ = 0.68; 90% | Total tree |
Authora
| No. of patients | No. of analyzed segments | No. of detectors | Reported interobserver agreementb
| Assessed segments |
---|---|---|---|---|---|
Rieker et al. 1997 | 30 | 210 | 1 | ρ=0.95 | Aortofemoral |
Walter et al. 2001 | 22 | 456 | 4 | κ = 0.71–0.76c
| Total tree |
Tins et al. 2001 | 35 | 219 | 1 | 78% | Aortofemoral |
Martin et al. 2003 | 41 | 1,312 | 4 | κw = 0.84 | Total tree |
Romano et al. 2004 | 42 | 3,402 | 4 | κ = 0.84;0.86d
| Total tree |
Romano et al. 2004 | 42 | 1,782 | 4 | κ = 0.85, 0.88, κ = 0.80e
| Total tree |
Catalano et al. 2004 | 50 | 1,137 | 4 | κ = 0.80 | Total tree |
Ota et al. 2004 | 24 | 470 | 4 | κ = 0.88 | Iliac |
Portugaller et al. 2004 | 50 | 740 | 4 | κ = 0.81 | Total tree |
Kock et al.f
| 73 | 2,268 | 4 | κw = 0.84 | Total tree |
Ouwendijk et al. 2005 | 79 | 2,419 | 16 | κw = 0.85 | Total tree |
Willmann et al. 2005 | 39 | 1,365 | 16 | κ = 0.85–1 | Total tree |
MDCTA | CEMRA | DSA | |
---|---|---|---|
Intermittent claudication (Fontaine II) | + | + | + |
Chronic critical ischemia (Fontaine III or IV) | − | + | + |
Short examination time | + | − | − |
Short postprocessing time | − | + | + |
Outpatient setting | + | + | − |
Availability | + | − | + |
Non-invasive technique/patient comfortb
| + | + | − |
Low diagnostic imaging costs | + | − | − |
Contrast media tolerance | − | + | − |
Three-dimensional imaging | + | + | − |
Non-interference of stentsc
| + | − | + |
Radiation risk | +(−)d
| − | +(−)d
|
Acute clinical setting | + | − | + |
Hemodynamic assessment | − | −a
| + |
Extraluminal pathology visualization | + | −a
| − |