石灰化病変の血管内腔評価における軌道同期ヘリカルスキャンを用いた下肢サブトラクションCT Angiographyの有用性

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Purpose: Massive calcification complicates the diagnosis of the blood vessel lumen in computed tomography angiography (CTA) of the arteries of the lower extremities. The purpose of this study was to evaluate subtraction CTA with the use of orbital synchronized helical scanning (OS-SCTA). Method: Phantom study: We performed OS-SCTA and non-OSCTA of a calcified vessel phantom (φ2.5 mm), and compared them with a non-calcified vessel phantom as the reference by full width at half maximum (FWHM) and full width at tenth maximum (FWTM) of maximum intensity projection (MIP) images. Clinical study: 58 patients with peripheral artery disease who were referred for angiography also underwent OS-SCTA. OS-SCTA was produced using MIP images. Findings were graded according to three categories: (1) stenosis greater than 50% or occluded; (2) stenosis less than 50%; (3) not detected due to insufficient image quality. OS-SCTA findings were compared with the angiographic findings for each arterial segment. Results: In the phantom study, FWHM showed no significant difference between OS-SCTA and the reference (P=0.135), whereas FWTM showed a significant difference (P<0.001). FWHM and FWTM showed a significant difference between non-OS-SCTA and the reference (P<0.001), due to misregistration with helical artifacts. In a clinical study comparing OS-SCTA with angiography, the sensitivity and specificity were 93.3% and 95.1% in calcified segments, 91.8% and 93.9% in non-calcified segments, and 92.2% and 94.6% in all segments. There was no significant difference between calcified segments and non-calcified segments (sensitivity: P=0.568, specificity: P=0.549). Conclusion: OS-SCTA is beneficial for the diagnosis of lower extremity arteries with vessel wall calcification, since it shows detection accuracy comparable to that of angiography.
公益社団法人日本放射線技術学会の論文

石灰化病変の血管内腔評価における軌道同期ヘリカルスキャンを用いた下肢サブトラクションCT Angiographyの有用性

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