Evaluation of peripheral arterial bypass grafts with multi-detector row CT angiography: comparison with duplex US and digital subtraction angiography.

Détails

ID Serval
serval:BIB_E80ABB7B96F9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Evaluation of peripheral arterial bypass grafts with multi-detector row CT angiography: comparison with duplex US and digital subtraction angiography.
Périodique
Radiology
Auteur(s)
Willmann J.K., Mayer D., Banyai M., Desbiolles L.M., Verdun F.R., Seifert B., Marincek B., Weishaupt D.
ISSN
0033-8419
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
229
Numéro
2
Pages
465-74
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article - Publication Status: ppublish
Résumé
PURPOSE: To assess the technical feasibility of multi-detector row computed tomographic (CT) angiography in the assessment of peripheral arterial bypass grafts and to evaluate its accuracy and reliability in the detection of graft-related complications, including graft stenosis, aneurysmal changes, and arteriovenous fistulas. MATERIALS AND METHODS: Four-channel multi-detector row CT angiography was performed in 65 consecutive patients with 85 peripheral arterial bypass grafts. Each bypass graft was divided into three segments (proximal anastomosis, course of the graft body, and distal anastomosis), resulting in 255 segments. Two readers evaluated all CT angiograms with regard to image quality and the presence of bypass graft-related abnormalities, including graft stenosis, aneurysmal changes, and arteriovenous fistulas. The results were compared with McNemar test with Bonferroni correction. CT attenuation values were recorded at five different locations from the inflow artery to the outflow artery of the bypass graft. These findings were compared with the findings at duplex ultrasonography (US) in 65 patients and the findings at conventional digital subtraction angiography (DSA) in 27. RESULTS: Image quality was rated as good or excellent in 250 (98%) and in 252 (99%) of 255 bypass segments, respectively. There was excellent agreement both between readers and between CT angiography and duplex US in the detection of graft stenosis, aneurysmal changes, and arteriovenous fistulas (kappa = 0.86-0.99). CT angiography and duplex US were compared with conventional DSA, and there was no statistically significant difference (P >.25) in sensitivity or specificity between CT angiography and duplex US for both readers for detection of hemodynamically significant bypass stenosis or occlusion, aneurysmal changes, or arteriovenous fistulas. Mean CT attenuation values ranged from 232 HU in the inflow artery to 281 HU in the outflow artery of the bypass graft. CONCLUSION: Multi-detector row CT angiography may be an accurate and reliable technique after duplex US in the assessment of peripheral arterial bypass grafts and detection of graft-related complications, including stenosis, aneurysmal changes, and arteriovenous fistulas.
Mots-clé
Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Aneurysm, Angiography, Digital Subtraction, Arterial Occlusive Diseases, Arteriovenous Fistula, Bioprosthesis, Blood Vessel Prosthesis Implantation, Female, Graft Occlusion, Vascular, Humans, Leg, Male, Middle Aged, Observer Variation, Postoperative Complications, Prospective Studies, Saphenous Vein, Sensitivity and Specificity, Tomography, X-Ray Computed, Ultrasonography, Doppler, Duplex, Vascular Patency
Pubmed
Web of science
Création de la notice
29/02/2008 17:45
Dernière modification de la notice
20/08/2019 16:10
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