CT ANGIOGRAPHY VERSUS INTRAARTERIAL DSA I N ABDOMINAL AORTIC-ANEURYSMS

Purpose: To evaluate if CT angiography is able to image all features n ecessary for the preoperative planning of abdominal aortic aneurysms ( accessory renal arteries, stenoses or occlusions of renal and iliac ar teries, patency of inferior mesenteric artery). Methods: CT angiograph y and DSA were performed on 27 patients with abdominal aortic aneurysm s. CT angiography was performed using a protocol that covered the abdo minal aorta and the pelvic arteries with a single spiral acquisition ( contrast dose: 150 ml, collimation: 5 mm, table feed: 7.5 mm/s, increm ent of reconstruction: 2 mm). Maximum intensity projections (MIP) and axial scans were compared with the results of intraarterial DSA. Resul ts: Using axial scans and sub-volume MIP, CTA accurately defined 7/8 a ccessory renal arteries, 13/13 occlusions and 9/12 high grade stenoses of renal and pelvic arteries. High-grade stenoses of the iliac arteri es were underestimated in two cases and overlooked in one case. CT ang iography was superior to DSA in imaging the inferior mesenteric artery . CT angiography precisely diagnosed 33 aneurysms of the iliac, renal and coeliac arteries. Conclusion: CT angiography using a single admini stration of intravenous contrast may replace preoperative DSA in most cases of abdominal aortic aneurysm.