CT ANGIOGRAPHY VERSUS INTRAARTERIAL DIGITAL SUBTRACTION ANGIOGRAPHY FOR ASSESSMENT OF AORTOILIAC OCCLUSIVE DISEASE

OBJECTIVE. The purpose of this study was to evaluate the accuracy of C T angiography (CTA) with a single helical acquisition for assessment o f stenoses and occlusions of the iliac arteries. SUBJECTS AND METHODS, In our prospective study, intraarterial digital subtraction angiograp hy and TV CTA were performed from the suprarenal aorta to below the fe moral bifurcation in 30 patients with vascular occlusive disease. Maxi mum-intensity-projection images in multiple views were also obtained. The accuracy of CTA with and without analysis of axial images was dete rmined. RESULTS, Sensitivity and specificity of CTA were 100% for ilia c artery occlusions with a confidence interval 85-100% and 97-100%, re spectively. When axial scans were interpreted, 14 of 15 high-grade (>7 5%) stenoses were recognized. Sensitivity and specificity of CTA were 93% (range, 68-100%) and 99% (range, 97-100%), respectively. When maxi mum intensity projections alone were analyzed, sensitivity for the dia gnosis of 15 high-grade stenoses was only 53% (range, 27-79%) because calcified plaques obscured six stenoses. CONCLUSION. CTA accurately re veals iliac artery occlusions. Observers of CT angiograms may overlook short stenoses in rare instances. Calcified plaques limit the use of maximum-intensity-projection images.