What is the role of CTA in the workup of peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

CTA is another modality used to image arterial disease. Unfortunately, it still requires a large amount of contrast media, and an upgraded CT scanner is needed to reconstruct helpful images.

CTA is another modality used to image arterial disease. It does have some pitfalls, such as the requirement for large amounts of contrast media, the necessity of synchronizing the image acquisition with the media administration, and the need for an upgraded CT scanner with postprocessing techniques to reconstruct helpful images. However, advances in technology now allow three-dimensional (3D) and four-dimensional (4D) reconstructions providing temporal information.

A small study that evaluated the diagnostic accuracy of “dynamic CTA” for lower-extremity PAOD found the sensitivity and specificity to be 98% and 97.1%, respectively, for diagnosing vessel stenosis, and 95.4% and 99.3%, respectively, for diagnosing vessel occlusion. [10] These figures may be compared with the standard CTA sensitivities and specificities of 96.6% and 92.2%, respectively, for vessel stenosis and 94.4% and 94.4%, respectively, for occlusion. The investigators demonstrated a clear improvement in diagnostic accuracy for PAOD with dynamic CTA over standard CTA, without increased radiation or contrast administration.


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