Comparative Imageological Study In Lower Extremity Arterial Stenosis Or Occlusion

Objective:To investigate the value of 64 slice CTA and 1.5T CE MRA in lower extremity arterial stenosis or occlusion compare with DSA. Holded the conclusion we found can help to figure out the next best exam before operation, when we reviewed the clinical and ultra sound information.Methods:48 cases of lower extremity arterial stenosis or occlusion were included in this study (male 34,female14, age range from 44-82years, mean age is62±9years).20 cases were exam by AQUILION 64 slices CT scan. Data was rebuilt by MIP(Maximum Intensity Projection), VR(Volume Rendering) with V3.0 software.And compared the results of CTA and DSA by Kappa analysis.28cases were exam by GE signa 1.5T HD MRI scan. Data was rebuilt by MIP(Maximum Intensity Projection) with Sun Advantage Workstation4.2 software.And compared the results of MRA and DSA by Kappa analysis.We classify the artery into four group, group 1:aortic artery and iliac artery; group 2:femoral artery and popliteal artery; group 3:anterior tibial artery,posterior tibial artery,fibular artery; group 4:dorsal artery of foot and arteriae plantaris. Also,classify the focus into 3 classes; class 1:no stenosis or stenosis is less than 50%; class 2:stenosis is more than 50%; class 3:occlusion focus.Results:1.comparative between DSA and CTA1.1 In Group 1:Among 76 arteries, we found 37 focus classify as class 1 focus, 29 focus classify as class 2 focus,14 focus classify as class 3 focus in DSA results; we found 37 focus classify as class 1 focus,30 focus classify as class 2 focus,13 focus classify as class 3 focus in CTA results; Kappa value is 0.9401.2 In Group 2:Among 80 arteries, we found 19 focus classify as class 1 focus, 45 focus classify as class 2 focus,12 focus classify as class 3 focus in DSA results; we found 24 focus classify as class 1 focus,45 focus classify as class 2 focus,12 focus classify as class 3 focus in CTA results; Kappa value is 0.9151.3 In Group 3:Among 84 arteries, we found 32 focus classify as class 1 focus,33 focus classify as class 2 focus,31 focus classify as class 3 focus in DSA results; we found 30 focus classify as class 1 focus,32 focus classify as class 2 focus,34 focus classify as class 3 focus in CTA results; Kappa value is 0.8911.4 In group 4:Among 56 arteries, there are 32 arteries without occlusion in DSA; there are 30 arteries without occlusion in CTA;2.comparative between DSA and CE MRA2.1 In Group 1:Among 108 arteries, we found 74 focus classify as class 1 focus,26 focus classify as class 2 focus,11 focus classify as class 3 focus in DSA results; we found 7 focus classify as class 1 focus,27 focus classify as class 2 focus, 12 focus classify as class 3 focus in CE MRA results; Kappa value is 0.9472.2 In Group 2:Among 80 arteries, we found 28 focus classify as class 1 focus, 61 focus classify as class 2 focus,25 focus classify as class 3 focus in DSA results; we found 23 focus classify as class 1 focus,62 focus classify as class 2 focus,28 focus classify as class 3 focus in CE MRA results; Kappa value is 0.8982.3 In Group 3:Among 120 arteries, we found 51 focus classify as class 1 focus,36 focus classify as class 2 focus,41 focus classify as class 3 focus in DSA results; we found 51 focus classify as class 1 focus,38 focus classify as class 2 focus,39 focus classify as class 3 focus in CE MRA results; Kappa value is 0.751.2.4 In group 4:Among 80 arteries, there are 47 arteries without occlusion in DSA; there are 42 arteries without occlusion in CE MRA;Conclusion:1,Compare with DSA,64 slices CT and 1.5TMRI can play an important role in stenosis or occlusion of aortic,iliac,femoral,popliteal artery and anterior tibial,posterior tibial,fibular artery;1.1,In aortic,iliac,femoral and popliteal artery, the Kappa value of CTA vs DSA and the Kappa value of CE MRA vs DSA are similar. CE MRA is a batter choice for no X-ray;1.2,In some cases with server calcification, CTA is batter than MRI to show calcification; but CE MRA can identify the stenosis or occlusion more precise than CTA;1.3,To exam anterior tibial artery,posterior tibial artery,fibular artery, CTA is more reliable than CE MRA for no vein pollution。2,The results of dorsal artery of foot and arteriae plantaris scan by CTA and CE MRA are not as reliable as DSA.