Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
Department of Radiology, University Hospital Zurich, Zurich, Switzerland.
Eur Radiol. 2021 Aug;31(8):5507-5513. doi: 10.1007/s00330-021-07692-5. Epub 2021 Feb 6.
The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation.
Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests.
The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively).
CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease.
• CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.
本研究旨在评估有症状外周动脉疾病（PAD）患者下肢容积 CT 灌注（CTP）在介入血管重建前后的变化。
前瞻性评估 29 例下肢有症状需要介入血管重建的 PAD 患者。所有患者均行下肢 CTP 扫描，并在介入前后进行血流动力学和血管造影评估。测定踝肱指数（ABI）。使用灌注软件根据无流出假设计算 CTP 参数。采用两室顺序模型。采用非参数检验评估 CTP 参数的差异。
该队列包括 24 例闭塞患者和 5 例重度狭窄患者。介入前/后平均血流量（BFpre 和 BFpost）分别为 7.42±2.66 和 10.95±6.64ml/100ml*min。介入前/后平均血容量（BVpre 和 BVpost）分别为 0.71±0.35 和 1.25±1.07ml/100ml。治疗肢体的 BFpost 和 BVpost 明显高于 BFpre 和 BVpre（p=0.003 和 0.02），而非治疗肢体无显著差异（p=0.641 和 0.719）。
CTP 可用于评估有症状 PAD 患者血管重建前后小腿肌肉的血流动力学差异。我们发现，症状肢体血管重建后 CTP 参数 BF 和 BV 明显增加。在未来，这种定量方法可能成为监测和治疗外周动脉疾病患者的非侵入性方法。
• CTP 成像可用于评估有症状 PAD 患者下肢血管重建前后的血流动力学差异。
• 这种定量方法可能成为监测和治疗 PAD 患者的非侵入性方法。
