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CT-perfusion in peripheral arterial disease – Correlation with angiographic and hemodynamic parameters


Autoři: Bert-Ram Sah aff001;  Patrick Veit-Haibach aff003;  Klaus Strobel aff007;  Martin Banyai aff008;  Martin W. Huellner aff003
Působiště autorů: Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland aff001;  Department of Cancer Imaging, King’s College London, London, England, United Kingdom aff002;  Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland aff003;  Department of Radiology, University Hospital Zurich, Zurich, Switzerland aff004;  University of Zurich, Zurich, Switzerland aff005;  Joint Department of Medical Imaging, University of Toronto, Toronto, Canada aff006;  Department of Radiology and Nuclear Medicine, Lucerne Cantonal Hospital, Lucerne, Switzerland aff007;  Department of Internal Medicine, Subdivision of Angiology, Lucerne Cantonal Hospital, Lucerne, Switzerland aff008;  Clinic for Angiology, University Hospital Zurich, Zurich, Switzerland aff009
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223066

Souhrn

Objective

The purpose of this study was the assessment of volumetric CT-perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) of the lower extremities, comparing it with established angiographic and hemodynamic parameters.

Materials and methods

Thirty-five consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularization were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment. Hemodynamic parameters, specifically ankle-brachial pressure index (ABI), ankle blood pressure (ABP), peak systolic velocity (PSV), and segmental pulse oscillography (SPO) level, were determined. Lesion length and degree of collateralization were assessed by interventional angiography. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters and correlations between CTP, hemodynamic and angiographic parameters were assessed with non-parametric tests.

Results

The cohort consisted of 27 subjects with an occlusion, and eight with a high-grade stenosis. The mean blood flow (BF) was 7.71 ± 2.96 ml/100ml*min-1, mean blood volume (BV) 0.71 ± 0.33 ml/100ml, and mean mean transit time (MTT) 7.22 ± 2.66 s. BF and BV were higher in subjects with longer lesions, and BV was higher in subjects with lower ABI. Significant correlations were found between lesion length and BV (r = 0.65) and BF (r = 0.52). Significant inverse correlations were found between BV and ABI and between BV and ABP (r = -0.56, for both correlations).

Conclusions

In our study, we have shown the feasibility of CTP for the assessment of PAD. In the future, this quantitative method might serve as a non-invasive method, possibly complementing the diagnostic workup of patients with peripheral arterial disease.

Klíčová slova:

Blood flow – Blood pressure – Blood volume – Body limbs – Hemodynamics – Legs – Lesions – Stenosis


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