Multi-detector row CT angiography appears consistent and accurate in the assessment of patients with peripheral arterial occlusive disease.

High-resolution MDCT is accurate in the preoperative evaluation of patients with renal cell carcinoma.

To investigate the possibility of reducing X-ray exposure during multidetector-row spiral computed tomographic (MDCT) angiography and to compare the image quality and diagnostic accuracy of different dosages with digital subtraction angiography (DSA) in the evaluation of the infra-renal aorta and lower extremities vessels. Seventy-five patients, randomly divided into three groups of 25 patients each, were evaluated for atherosclerotic disease with four-row spiral CT angiography (4x2.5 mm) and DSA. MDCT scanning parameters were kept constant, except for milliamperage (mAs): group A: 50 mAs; group B: 100 mAs; group C: 130 mAs. Images were analysed by two vascular radiologists in consensus. DSA represented the standard of reference. The diagnostic value of MDCT and total radiation exposure were evaluated for each data set. The simulated effective dose was 3.7 mSv for 50 mAs, 8.2 mSv for 100 mAs and 13.7 mSv for 130 mAs for men, and 4 mSv for 50 mAs, 8.9 mSv for 100 mAs and 14.8 mSv for 130 mAs for women. The dose reduction was 74% for group A and 40% for group B. The evaluation of the presence and degree of stenoses revealed a sensitivity, specificity, accuracy, PPV and NPV of 96%, 94%, 95%, 83% and 99% for Group A (50 mAs), 96%, 96%, 96%, 89% and 99% for Group B (100 mAs) and 98%, 96%, 97%, 91% and 100% for the standard dose protocol, Group C (130 mAs). Low-dose scanning is thus a feasible and accurate option for four-row CT angiography of the peripheral vessels. This technique provides substantial reduction of the radiation dose delivered to the patient while maintaining optimal diagnostic accuracy.

The purpose of our study was to evaluate multislice computed tomography (MSCT) in the assessment of patients with clinical, laboratory, and US suspicion of pancreatic neoplasm, and to evaluate resectability status. Forty-six patients with a suspected pancreatic tumor underwent MSCT. After a preliminary precontrast survey, a postcontrast scan was performed in the arterial and portal venous phase with the following protocol: 4×1-mm collimation; 1.25-and 5-mm slice thickness width, respectively, and 1-and 5-mm reconstruction interval. In all patients pathological correlation was obtained. The evaluation of all images provided a diagnosis in 44 patients, with a sensitivity, specificity, and accuracy of 97, 80, and 96%, respectively. The MSCT correctly provided a diagnosis of unresectability with sensitivity of 96%, specificity of 86%, and accuracy of 93%. Evaluation of 1-mm slices demonstrated 83 of the 91 liver metastases found at surgery; conversely, the 5-mm slices detected only 76 of these lesions. Infiltration of peripancreatic major vessels was demonstrated, and was confirmed at surgery in 18 patients. High-resolution MSCT improves prediction of resectability in patients with suspected pancreatic carcinoma. Parenchymal and vascular information can be achieved with a single MSCT examination.

MDCT angiography is very accurate and robust, even for the assessment of renal artery stenosis, and has the potential to become a viable substitute, in most cases, for diagnostic catheter-based DSA.