CT angiography of the abdominal arteries

Abstract

Arterial DSA is being replaced by less invasive technique such as CTA, MRA, and color-coded duplex ultrasound. With their three-dimensional capabilities, both CTA and MRA are potent tools for imaging of the abdominal arteries that provide highly accurate and reproducible results. At present, however, a standard CTA provides similar information as a high-end, state-of-the-art Gd-MRA, but it is much easier, costs much less, and can be performed on an average spiral CT scanner.

Contrast-Enhanced MR Angiography Is Not More Accurate Than Unenhanced 2D Time-of-Flight MR Angiography for Determining ≥70% Internal Carotid Artery Stenosis

“…9,43 Although there is still ongoing controversy over whether the results from CTA match completely with selective intra-arterial angiography or rotational angiography, 44,45 CTA has been favorably evaluated against DSA in ICA stenosis assessment, 4,18,19,29,30 with some patient series achieving CTA sensitivity and specificity for detecting Ն70% carotid artery stenosis in the range of 98%-100%. 4,19,27,29,30 Also, in a direct comparison of CTA with DUS by using DSA as a reference standard, CTA showed a better correlation coefficient, sensitivity, and specificity in evaluating ICA stenosis than did DUS. 30 Randoux et al 4 assessed gadolinium-enhanced MRA and CTA against DSA in detecting severe ICA narrowing, and CTA showed a better correlation with DSA across all stenosis values compared with MRA.…”

“…4,46,47 CT angiography is less prone to overestimating carotid artery stenosis because it is an anatomically weighted vascular imaging technique with a higher spatial resolution due to thinner sections, with pixel size being typically Ͻ0.4 mm on MDCT. 19,38,48 This is in contrast to gadolinium-en- hanced MRA, which has lower resolution, with a pixel size typically approximately 1 mm, and which is physiologically weighted and therefore subject to pulsation and turbulence artifacts. Additionally, CTA is capable of distinguishing total ICA occlusion from hairline lumen, which has an important prognostic value for patients being considered for endarterectomy.…”

“…The literature reports excellent and robust sensitivities and specificities of DUS, MRA, and CTA in distinguishing Ͻ70% and Ͼ70% ICA stenosis. 4,5,9,[15][16][17][18][19][20] Nonetheless DSA is still used in more complex cases, for example, ones with multisegmental disease.…”

“…4,5,10,18,19,[27][28][29][30][31][32][33][34][35][36][37] CTA compared with MRA and DUS also has good spatial resolution, less flow dependence, and provides luminal and extraluminal data that augment evaluation of vascular narrowing. 4,[32][33][34][36][37][38][39][40] We hypothesized that unenhanced 2D TOF MRA provides sufficient and reliable vascular data to serve as a robust screening test in determining Ն70% narrowing.…”

Multislice CT in the pre- and postinterventional evaluation of mesenteric perfusion

“…Computed tomography angiography (CTA) is a valuable minimally invasive tool for the visualization of visceral vasculature [1,2]. When compared to conventional angiography, CTA is less expensive, saves examination time, and may save iodinated contrast dose and radiation exposure of the patient [3,4].…”