Quick evaluation of lower leg ischemia in patients with peripheral arterial disease by time maximum intensity projection CT angiography: a pilot study

• Published in: BMC medical imaging Vol. 21; no. 1; pp. 7 - 8
• Main Authors: Zhang, Daming, Zhou, Xueyan, Zhang, Haiping, Fan, Xiaobing, Lin, Zehong, Xue, Huadan, Wang, Yining, Jin, Zhengyu, Chen, Yuexin
• Format: Journal Article
• Language: English
• Published: London BioMed Central 06.01.2021; BioMed Central Ltd; BMC
• Subjects: Accuracy; Angiography; Attenuation; Blood vessels; Calves; Care and treatment; Computed tomographic angiography; Computed tomography; CT imaging; Diagnosis; Diagnostic systems; Evaluation; Extremities; Feasibility studies; Imaging; Ischemia; Leg; Maximum intensity projection; Medical imaging; Medicine; Medicine & Public Health; Musculoskeletal imaging; Occlusion; Patients; Peripheral arterial disease; Peripheral vascular diseases; Radiology; Research Article; Runoff; Software; Standard deviation; Statistical analysis; Stenosis; Veins & arteries; Germany; Peripheral arterial disease; Computed tomographic angiography; Maximum intensity projection
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/s12880-020-00537-5

Background The purpose of this study is to evaluate a new method involving time maximum intensity projection (t-MIP) postprocessed from dynamic computed tomographic angiography (dyn-CTA) in diagnosing peripheral arterial disease (PAD). Methods A population of 34 patients with known PAD was examined with a combined CTA protocol consisting of a standard CTA (s-CTA) scan of the lower extremities and a dyn-CTA scan of the calves. For each lower leg, t-MIP images consisting of the MIP 0 (sagittal MIP), MIP +θ (45° lateral MIP), and MIP −θ (− 45° lateral MIP) were automatically generated from dyn-CTA. An objective evaluation of the vascular CT attenuation of the best enhancement phase of dyn-CTA and t-MIP was measured; a subjective evaluation of vessel stenosis and occlusion was performed, assigning a score for t-MIP and s-CTA. The CT attenuation of t-MIP and dyn-CTA was compared, as were the runoff scores of t-MIP and s-CTA. Results The CT attenuation of t-MIP CTA of three vascular segments from 68 lower extremities was higher than that of the best enhancement phase of dyn-CTA and s-CTA, with statistically significant differences at the posterior tibial artery and fibular artery (all p  < 0.05). There were strong correlations (r ≥ 0.75, p < 0.05) of the runoff scores between t-MIP and s-CTA. Conclusions There is potential clinical applicability of t-MIP in assisting with the diagnosis of lower leg vascular stenosis in dyn-CTA with reliable diagnostic accuracy and convenient immediacy.