MDCT-imaging of peripheral arterial disease

With the design and development of advanced computed tomography (CT) techniques and applications, like the newest generation of 16-detector-row CTs, CT angiography of the lower limb becomes a feasible tool for imaging peripheral vascular disease. Due to several advantages, compared with conventional digital subtraction angiography (DSA), including minimal invasiveness, CT angiography competes against diagnostic DSA in several clinical situations. 16-DCT offers the possibility to acquire thin slices from the diaphragm to the ankle in less than 40 sec. Easily, a data set of 800 to 1200 transverse slices may be created. To use transverse reconstructions alone to read these volumetric data sets is not appropriate. Powerful post-processing tools for volumetric analysis are required so that routine interpretation can be performed as efficiently and accurately as transverse section review. Because of its widespread availability and applicability, CT angiography of the lower extremities may be applied to patients in a pre- or post-procedural situation and also serves as a first line modality in patients with acute onset of clinical symptoms. Although multidetector CT arteriography is rapidly achieving clinical acceptance, further studies need to be performed to fully evaluate the clinical value of this method of peripheral arterial imaging. This article reviews the current status of multidetector CT peripheral arteriography, including indications, technical details, image post-processing, radiation exposure, and clinical results.