The Egyptian Journal of Radiology and Nuclear Medicine (Sep 2019)
Comparative study between duplex ultrasound and 160-multidetectors CT angiography in assessment of chronic lower limb ischemia
Abstract
Abstract Purpose of the study This study is aiming to evaluate the role of duplex ultrasonography in comparison with multidetector computed tomography angiography (MDCT) angiography in the assessment of lower limb ischemia. The context The study group includes 54 patients with unilateral or bilateral chronic lower limb ischemic disease—who have come to the Department of Radiology at Aswan University Hospital for CT angiography—and Doppler ultrasonography (US) was done for comparison. Out of the 54 patients, 6 were asymptomatic (Fontain’s stage 1), 16 had intermittent claudication when walking more than 200 m (Fontain’s stage 2a), 10 had intermittent claudication when walking more than 200 m (Fontain’s stage 2b), 10 had rest pain (Fontain’s stage 3), and 12 had trophic changes, ulcers, or gangrene (Fontain’s stage 4). Results The study involved 54 patients, 24 men (44.4%) and 30 women (55.6%). They were between 33 and 75.0 years with mean 59.56 years and standard deviation ± 10.3. Out of them, there were 4 patients who had above-knee amputation of one leg. There were 34 patients who are chronic smokers 63.0%, 40 had diabetes 74.1%, 26 had hypertension 48.1%, and 4 are cardiac 7.4%. There was good reliability and agreement between CT and Doppler techniques with significant kappa agreement in all measurements. As regards the external iliac artery, we found that the kappa agreement was 0.87; common femoral artery, kappa agreement was 0.88; superficial femoral artery, kappa agreement was 0.82 at the upper third, 0.76 at the middle third, and 0.86 at the lower third; popliteal artery, kappa agreement was 0.87; peroneal artery, kappa agreement was 0.88; posterior tibial artery, kappa agreement was 0.93; and anterior tibial artery, kappa agreement was 0.88. Conclusion Both MDCT angiography and duplex US have a good predictive value of chronic lower limb ischemia, but the combination of them has better diagnostic accuracy.
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