Popliteal vascular disease: Evaluation with spiral CT angiography

PURPOSE: To evaluate the potential role of spiral computed tomographic (CT) angiography in the diagnosis of popliteal artery disease. MATERIALS AND METHODS: In 26 consecutive patients referred for popliteal arteriography, the authors performed additional spiral CT angiography with the following protocol: Bd-mm collimation, 4-6 mm/sec table speed, and 2-3-mm overlap during 32 seconds, with use of 110 mL of contrast medium. Axial transverse sections and shaded surface display and multiplanar reformation reconstruction images were analyzed. All patients underwent previous Doppler ultrasound examination. RESULTS: In the 52 arteries imaged, arteriography showed 14 isolated hemodynamically significant (>50% diameter reduction) stenoses (due to popliteal artery entrapment in one case), four occluded arteries, and 11 aneurysms. CT angiography also demonstrated these 14 stenoses and four occlusions. However, axial transverse views at CT angiography showed that eight of the stenoses were associated with other abnormalities (aneurysm in six, popliteal artery entrapment syndrome in one, and cystic adventitial disease in one) and that two of the occlusions resulted from popliteal artery entrapment syndrome (n = 1) and thrombosis of an aneurysm (n = 1). CT angiography also demonstrated the 11 aneurysms shown with arteriography. CONCLUSION: Popliteal artery lesions can be diagnosed with spiral CT angiography, which provides detailed information on the wall and diameter of the artery and relation of the artery to adjacent structures.