DOI QR코드

DOI QR Code

Effect of Patient Characteristics on Vessel Enhancement at Lower Extremity CT Angiography

  • Masuda, Takanori (Department of Radiological Technology, Tsuchiya General Hospital) ;
  • Nakaura, Takeshi (Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University) ;
  • Funama, Yoshinori (Department of Medical Physics, Faculty of Life Sciences, Kumamoto University) ;
  • Sato, Tomoyasu (Department of Diagnostic Radiology, Tsuchiya General Hospital) ;
  • Higaki, Toru (Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University) ;
  • Kiguchi, Masao (Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University) ;
  • Yamashita, Yukari (Department of Radiological Technology, Tsuchiya General Hospital) ;
  • Imada, Naoyuki (Department of Radiological Technology, Tsuchiya General Hospital) ;
  • Awai, Kazuo (Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University)
  • Received : 2017.05.11
  • Accepted : 2017.08.25
  • Published : 2018.04.01

Abstract

Objective: To evaluate the effect of patient characteristics on popliteal aortic contrast enhancement at lower extremity CT angiography (LE-CTA) scanning. Materials and Methods: Prior informed consent to participate was obtained from all 158 patients. All were examined using a routine protocol; the scanning parameters were tube voltage 100 kVp, tube current 100 mA to 770 mA (noise index 12), 0.5-second rotation, 1.25-mm detector row width, 0.516 beam pitch, and 41.2-mm table movement, and the contrast material was 85.0 mL. Cardiac output (CO) was measured with a portable electrical velocimeter within 5 minutes of starting the CT scan. To evaluate the effects of age, sex, body size, CO, and scan delay on the CT number of popliteal artery, the researchers used multivariate regression analysis. Results: A significant positive correlation was seen between the CT number of the popliteal artery and the patient age (r = 0.39, p < 0.01). A significant inverse correlation was observed between the CT number of the popliteal artery and the height (r = -0.48), total body weight (r = -0.52), body mass index (r = -0.33), body surface area (BSA) (r = -0.56), lean body weight (r = -0.56), and CO (r = -0.35) (p < 0.001 for all). There was no significant correlation between the enhancement and the scan delay (r = 0.06, p = 0.47). The BSA, CO, and age had significant effects on the CT number (standardized regression: BSA -0.42, CO -0.22, age 0.15; p < 0.05, respectively). Conclusion: The BSA, CO, and age are significantly correlated with the CT number of the popliteal artery on LE-CTA.

Keywords

References

  1. Criqui MH, Fronek A, Barrett-Connor E, Klauber MR, Gabriel S, Goodman D. The prevalence of peripheral arterial disease in a defined population. Circulation 1985;71:510-515 https://doi.org/10.1161/01.CIR.71.3.510
  2. Schroll M, Munck O. Estimation of peripheral arteriosclerotic disease by ankle blood pressure measurements in a population study of 60-year-old men and women. J Chronic Dis 1981;34:261-269 https://doi.org/10.1016/0021-9681(81)90031-X
  3. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999- 2000. Circulation 2004;110:738-743 https://doi.org/10.1161/01.CIR.0000137913.26087.F0
  4. Chetter IC, Dolan P, Spark JI, Scott DJ, Kester RC. Correlating clinical indicators of lower-limb ischaemia with quality of life. Cardiovasc Surg 1997;5:361-366 https://doi.org/10.1016/S0967-2109(97)00011-2
  5. Bloor K. Natural history of arteriosclerosis of the lower extremities: Hunterian lecture delivered at the Royal College of surgeons of England on 22nd April 1960. Ann R Coll Surg Engl 1961;28:36-52
  6. Dormandy J, Heeck L, Vig S. The fate of patients with critical leg ischemia. Semin Vasc Surg 1999;12:142-147
  7. Adam DJ, Beard JD, Cleveland T, Bell J, Bradbury AW, Forbes JF, et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet 2005;366:1925-1934 https://doi.org/10.1016/S0140-6736(05)67704-5
  8. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 2007;45 Suppl S:S5-S67 https://doi.org/10.1016/j.jvs.2006.12.037
  9. Napoli A, Anzidei M, Zaccagna F, Cavallo Marincola B, Zini C, Brachetti G, et al. Peripheral arterial occlusive disease: diagnostic performance and effect on therapeutic management of 64-section CT angiography. Radiology 2011;261:976-986 https://doi.org/10.1148/radiol.11103564
  10. Bae KT. Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 2010;256:32-61 https://doi.org/10.1148/radiol.10090908
  11. Schernthaner R, Stadler A, Lomoschitz F, Weber M, Fleischmann D, Lammer J, et al. Multidetector CT angiography in the assessment of peripheral arterial occlusive disease: accuracy in detecting the severity, number, and length of stenoses. Eur Radiol 2008;18:665-671 https://doi.org/10.1007/s00330-007-0822-8
  12. Pollak AW, Norton PT, Kramer CM. Multimodality imaging of lower extremity peripheral arterial disease: current role and future directions. Circ Cardiovasc Imaging 2012;5:797-807 https://doi.org/10.1161/CIRCIMAGING.111.970814
  13. Yanaga Y, Awai K, Nakaura T, Utsunomiya D, Oda S, Hirai T, et al. Contrast material injection protocol with the dose adjusted to the body surface area for MDCT aortography. AJR Am J Roentgenol 2010;194:903-908 https://doi.org/10.2214/AJR.09.3460
  14. Boer P. Estimated lean body mass as an index for normalization of body fluid volumes in humans. Am J Physiol 1984;247(4 Pt 2):F632-F636
  15. Mosteller RD. Simplified calculation of body-surface area. N Engl J Med 1987;317:1098
  16. Hume R. Prediction of lean body mass from height and weight. J Clin Pathol 1966;19:389-391 https://doi.org/10.1136/jcp.19.4.389
  17. Hallynck TH, Soep HH, Thomis JA, Boelaert J, Daneels R, Dettli L. Should clearance be normalised to body surface or to lean body mass? Br J Clin Pharmacol 1981;11:523-526 https://doi.org/10.1111/j.1365-2125.1981.tb01163.x
  18. Itoh S, Ikeda M, Satake H, Ota T, Ishigaki T. The effect of patient age on contrast enhancement during CT of the pancreatobiliary region. AJR Am J Roentgenol 2006;187:505-510 https://doi.org/10.2214/AJR.05.0541
  19. Awai K, Kanematsu M, Kim T, Ichikawa T, Nakamura Y, Nakamoto A, et al. The optimal body size index with which to determine iodine dose for hepatic dynamic CT: a prospective multicenter study. Radiology 2016;278:773-781 https://doi.org/10.1148/radiol.2015142941
  20. Kohn JC, Lampi MC, Reinhart-King CA. Age-related vascular stiffening: causes and consequences. Front Genet 2015;6:112
  21. Bae KT, Heiken JP, Brink JA. Aortic and hepatic contrast medium enhancement at CT. Part II. Effect of reduced cardiac output in a porcine model. Radiology 1998;207:657-662 https://doi.org/10.1148/radiology.207.3.9609887
  22. van Kuijk JP, Flu WJ, Chonchol M, Welten GM, Verhagen HJ, Bax JJ, et al. The prevalence and prognostic implications of polyvascular atherosclerotic disease in patients with chronic kidney disease. Nephrol Dial Transplant 2010;25:1882-1888 https://doi.org/10.1093/ndt/gfp756
  23. Fleischmann D. CT angiography: injection and acquisition technique. Radiol Clin North Am 2010;48:237-247, vii https://doi.org/10.1016/j.rcl.2010.02.002

Cited by

  1. Aortic CT angiography using the double region of interest timing bolus technique: feasibility of 80 kVp scanning in lean patients vol.35, pp.11, 2018, https://doi.org/10.1007/s10554-019-01660-3
  2. Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery vol.28, pp.3, 2020, https://doi.org/10.1177/1708538119899317