The added value of CT virtual angioscopy to MDCT angiography in the evaluation of aortic diseases

Abstract

Purpose

Incorporation of virtual angioscopy (VA) in the diagnostic work-up of aortic diseases could improve the clinical value and efficiency of multidetector computed tomography angiography (MDCTA). We aim to evaluate the clinical usefulness of virtual aortic navigation by CT angiography in various aortic diseases as a complement to standard MDCTA.

Materials and methods

We retrospectively selected 211 patients who performed MDCTA for suspected or operated aortic diseases. VA endoluminal images of the aorta were obtained by a fly-through technique. Two senior vascular radiologists independently evaluated all MDCTA images. After 1 month, the same two radiologists independently reviewed the MDCTA images combined with CTVA images. The respective accuracy of CTVA in delineating aortic abnormalities was compared to that of MDCTA using Fisher's exact test. The Fleiss kappa (κ) statistic was used to assess the inter-reader agreement (IRA).

Results

We detected 229 abnormalities in 203 patients on MDCTA and 231 abnormalities in 205 patients on CTVA. CTVA provided significant additional findings in 63.8% (146/229) of all abnormalities diagnosed by MDCTA (p < 0.001, odd ratio [OR] = 42). Although CTVA diagnosed two abnormalities overlooked by MDCTA, the value was statistically insignificant (p = 0.787, OR = 1.3). Regarding postoperative abnormalities, the CTVA added significant additional findings over MDCTA (p = 0.006, OR = 87.4). The overall IRA for the performance of CTVA was good (κ = 0.699).

Conclusions

CTVA yields extra findings and improves diagnostic efficiency of MDCTA, especially in postoperative patients.

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Acknowledgements

The authors thank all staff members and colleagues in the Radiology Departments-Zagazig University for their helpful cooperation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Correspondence to Mohammad Abd Alkhalik Basha.

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Basha, M.A.A., Salem, A.F., Azmy, T.M. et al. The added value of CT virtual angioscopy to MDCT angiography in the evaluation of aortic diseases. Abdom Radiol 45, 2576–2584 (2020). https://doi.org/10.1007/s00261-020-02607-2

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Keywords

  • Computed tomography angiography
  • Virtual angioscopy
  • Aortic diseases