3-DIMENSIONAL SPIRAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY - AN ALTERNATIVE IMAGING MODALITY FOR THE ABDOMINAL-AORTA AND ITS BRANCHES

Purpose: We sought to apply a new technique of computed tomographic an giography (CTA) to the preoperative and postoperative assessment of th e abdominal aorta and its branches. Methods: After a peripheral intrav enous contrast injection, the patient is continuously advanced through a spiral CT scanner, while maintaining a 30-second breath-hold. Thirt y-five patients with abdominal aortic, renal, and visceral arterial di sease have undergone CTA. Results: Diagnostic three-dimensional images were obtained in patients with aortic aneurysms (n = 9), aortic disse ctions (n = 4), and mesenteric artery stenoses (n = 4). The technique has also been used to assess vessels after operative reconstruction or endovascular intervention in 18 patients. These preliminary studies h ave correlated well with conventional arteriographic findings. In aneu rysmal disease both the lumen and mural thrombus and associated renal artery stenoses are visualized. The true and false channels of aortic dissections and the perfusion source of the visceral vessels are clear ly shown; patency of visceral and renal reconstruction or stent placem ent are confirmed. CTA is relatively noninvasive and can be completed in less time than conventional angiography with less radiation exposur e. Conclusions: This initial experience suggests that CTA may be a val uable alternative to conventional arteriography in the evaluation of t he aorta and its branches.