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

Abstract

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 MIP0 (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.

Association of lower extremity peripheral arterial disease with quantitative muscle features from computed tomography angiography

“…The comparison of this study with our previously published work [20,31] can be found in Table S1. The reproducibility of image evaluation results between the two radiologists was excellent for the DSA score (ICC, 0.978; 95% CI, 0.961-0.988; p < 0.001) and CTA score (ICC, 0.992; 95% CI, 0.990-0.994; p < 0.001).…”

“…MRA is also useful for assessing PAD anatomy and the presence of stenosis, but it may be inaccurate in arteries treated with metal stents. Furthermore, there are many new methods for PAD severity assessment, such as deep learning-based classification models [ 32 ], non-contrast QISS-MRA [ 33 , 34 ], near infrared spectroscopy [ 35 ], and some dynamic imaging technology [ 31 , 36 ].…”

“…b Feature names corresponding to (a). The numbers before the feature names in b corresponding to the leftmost line number in a classification models [32], non-contrast QISS-MRA [33,34], near infrared spectroscopy [35], and some dynamic imaging technology [31,36].…”