Diagnostic Accuracy of Sixty Four Multi-Slice CT Angiography in Assessment of Arterial Cut-Off and Run-Off in Comparison with Surgical Findings

Background/Objective: The accurate anatomic mapping and determination of the severity of arterial disease an important health problem of the elderly is of great significance. We aimed to determine the diagnostic value of 64-multislice CT angiography (MSCTA) in arterial disease in run-off and cut-off sites, taking into consideration the results of surgical findings of our study as a standard of reference.
Patients and Methods: Throughout the study, MSCTA followed by an operative intervention was carried out on a total of 38 patients with clinical signs and symptoms suggestive of arterial disease (AD) and all had the indication for vascular surgery. The mean age of patients was 34±15.86 (range, 23 to 93) years. MSCTA was executed using a 64-slice CT scanner, during the arterial phase of injecting the nonionic, contrast medium with a power injector at the rate of 5 ml/sec into the antecubital vein and exploration and revascularization of peripheral arterial disease was performed intraoperatively.
Results: The most common cause of vascular occlusion was atherosclerosis and arterial disease was more common in the lower extremities. The most frequent site of stenosis due to MSCTA findings was in the superficial femoral artery. Spearman’s correlation coefficients showed a high degree of agreement amongst the raters. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy of MSCTA compared to surgery were 83.8%, 96%, 96.8%, 81.3% and 89%, respectively. MSCTA findings were compared with surgery as a standard of reference which showed concordance in the majority of cases (81.6%). Cut-off sites were correctly identified by MSCTA in 97.3% of the patients and the most common sites of discordance observed in our study were in run-off sites (18.2%).
Conclusion: MSCTA angiography as a novel diagnostic modality may be a suitable alternative and a viable choice for routine clinical diagnosis.