Multidetector Ct Angiography v/S Colour Doppler Ultrasonography in the Diagnosis of Peripheral Arterial Diseases of Lower Extremities

Abstract

CONTEXTPeripheral arterial disease of the lower extremity is an important cause of morbidity and affects 10 million people in India. AIMS AND OBJECTIVESThe aims of this study were to assess the colour Doppler ultrasonography findings of lower limbs in patients with peripheral arterial disease by studying the spectral flow pattern and peak systolic velocity and also to assess the severity of stenosis and correlation of severity of stenosis on USG Doppler and MDCT angiography. MATERIALS AND METHODSThe study included 29 patients attending surgery, Ortho OPD Government Medical College of Calicut with signs and symptoms of peripheral arterial diseases of lower limbs from January 2014 to October 2015 who underwent colour Doppler ultrasonography and MDCT angiography to know the severity of peripheral arterial diseases of lower extremities and to compare various grades of stenosis by studying the spectral flow patterns in colour Doppler ultrasonography and contrast opacification and diameter reduction in MDCT angiography. RESULTSIn our study, 29 patients with intermittent claudication, numbness, and pain in the legs were selected. Majority of the patients were males and below 50 yrs. In our study, detection of totally occluded segments were better in MDCT angiography on comparing with Doppler USG. Most of the arteries showed good total agreement between Doppler and MDCT angiography. Aortoiliac group of vessels showed more than 80% total agreement between Doppler and MDCT angiography. Femoropopliteal group vessels showed more than 75% total agreement. Infrapopliteal group of vessels showed more than 50% total agreement. CONCLUSIONMDCT angiography is more sensitive in detecting lesions of suprapopliteal group of vessels and also lesions with total occlusion of the lumen in comparison to Doppler ultrasonography. Imaging plays an important role in the management of the patients with peripheral arterial disease. Due to the limitations of the Doppler ultrasound, CT angiography is used prior to any vascular intervention is required in peripheral arterial diseases.

Diagnostic Accuracy of Color Doppler and Calcium Scoring versus Dual-Energy Computed Tomography Angiography in the Assessment of Peripheral Arterial Diseases of Lower Limb

“…However, there was an agreement with CTA in only 24/29 (86.2%) cases, thus showing that color Doppler had a sensitivity of 86.2% and specificity of 76.9% in detection of atheromatous changes. ese findings are in agreement with the observations of Dev et al [12] and Peedikayil et al [13] who also found that USG has lower sensitivity and specificity as compared to CTA in detection of luminal narrowing, irregularity, calcification, and atheromatous changes.…”

“…[ 12 ] and Peedikayil et al . [ 13 ] who also found that USG has lower sensitivity and specificity as compared to CTA in detection of luminal narrowing, irregularity, calcification, and atheromatous changes.…”

Role of multidetector computed tomography angiography in evaluation of peripheral arterial disease

“…22 Peedikayil et al did a study of 29 patients with intermittent claudication and showed MDCTA (7.4%) detected more number of lesions of supra-popliteal group of vessels with total occlusion as compared to colour Doppler (6.3%). 24 In this study we found that MDCTA is a very useful modality in detecting peripheral arterial disease of the extremities and as compared to Colour Doppler, MDCTA detected more number of disease segments, MDCTA has the advantages of being more widely available as compared to DSA which is invasive and requires more operator expertise and experience.…”

Comparison of Color Doppler and computed tomography angiography (CTA) in arterial disease in patients with lower limb ischemia.

“…12 Tibioperoneal trunk divide into tibial artery(posterior) which pass medially descend to the foot and peroneal pass laterally. 13 This study is planned to compare for diagnosis of various grades of stenosis to assess the benefits and drawbacks of each modality by learning the spectral flow patterns in color Doppler ultrasonography with contrast pacification and diameter reduction in CT angiography. This study will also help in generating local data which can be helpful later on regarding choice of modality for diagnosis of arterial disease in patients with lower limb ischemia.…”