Comparative Study of Ultrasound Doppler and 128-Multi-Detector CT in Assessment of Upper Extremity Ischemia in High-Risk Patients

Abstract

Ischemia at the upper extremity is considered one of the disabling and frequent causes of blind medical care failure. Non- invasive techniques as CTA and Doppler could effectively determine stenosis grades up to occlusion of the upper extremity, particularly if they impact the vessels proximal to the wrist also they can characterise the thrombus characters and recanalisation. The study was a prospective study carried out on 30 patients with upper extremity ischemia during the period from April 2019 to April 2020 at the Radiology department of ZagazigUniversity hospitals. All patients presented with signs of ischemia as claudication, colour changes, pulselessness and their age ranged between 45 to 70 years. All patients underwent complete history taking and clinical examination, the results were correlated to conventional angiography. Overall, in the present study, Doppler US has a sensitivity of 86.6 %, a specificity of 100%, PVP of 100% and PVN of 91.3%. CTA has a sensitivity of 93.3 %, the specificity of 100%, PVP of 100% and PVN of 95.45 %.CTA was more sensitive in milder degrees (Grades I& II) of thromboembolism and stenosis but no significant difference in severe cases (Grades III &IV). Segmental length assessment and collateral circulation were better noted on CT Angiography.