Vascular > PE

Radiology 2001 Jun;219(3):629-36

Peripheral pulmonary arteries: how far in the lung does multi-detector row spiral ct allow analysis?

Ghaye B, Szapiro D, Mastora I, Delannoy V, Duhamel A, Remy J, Remy-Jardin M.

Department of Radiology, University Center Hospital Calmette, Blvd Jules Leclerc, 59037 Lille Cedex, France (B.G., D.S., I.M., J.R., M.R.J.).

PURPOSE: To analyze the influence of multi-detector row spiral computed tomography (CT) on identification of peripheral pulmonary arteries. MATERIALS AND METHODS: Peripheral pulmonary arteries were analyzed on optimally opacified contrast material-enhanced spiral CT angiograms in 30 patients devoid of pleuroparenchymal disease who underwent scanning with multi-detector row CT (collimation, 4 x 1 mm; pitch, 1.7-2.0; scanning time, 0.5 second). Two series of scans were systematically generated from each data set, 1.25-mm-thick (group 1) and 3-mm-thick (group 2) sections, leading to the analysis of 600 segmental (20 arteries per patient), 1,200 subsegmental (40 arteries per patient), 2,400 fifth-order (80 arteries per patient), and 4,800 sixth-order (160 arteries per patient) pulmonary arteries in each group. RESULTS: Multi-detector row CT with reconstructed scans of 1.25-mm-thick sections (group 1) allowed (a) analysis of a significantly higher percentage of subsegmental arteries (94% in group 1 vs 82% in group 2; P <.001) and (b) a significantly higher percentage of fifth- and sixth-order arteries, respectively, identified in 74% and 35% of cases in group 1 and 47% and 16% in group 2 (P <.001). The causes for inadequate depiction of subsegmental branches in group 1 were partial volume effect (43%), anatomic variants (39%), and cardiac (17%) and respiratory (1%) motion artifacts. CONCLUSION: Multi-detector row CT with reconstructed scans of 1.25-mm-thick sections enables accurate analysis of peripheral pulmonary arteries down to the fifth order on spiral CT angiograms.

PMID: 11376246

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