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Diagnostic Accuracy of CT Angiography in the Evaluation of Stenosis in Lower Limbs: Comparison Between Visual Score and Quantitative Analysis Using a Semiautomated 3D Software

Iezzi, Roberto MD; Santoro, Marco MD, PhD; Dattesi, Roberta MD; la Torre, Michele Fabio MD; Guerra, Alessandra MD; Di Stasi, Carmine MD; Maria Antonuccio, Enzo Gabriele MD; Marano, Riccardo MD; Bonomo, Lorenzo MD

Journal of Computer Assisted Tomography: May/June 2013 - Volume 37 - Issue 3 - p 419–425
doi: 10.1097/RCT.0b013e31828730ed
Cardiovascular Imaging

Objective To assess the accuracy of a semiautomated 3-dimensional (3D) computed tomographic angiography software in the evaluation of lower limb stenoses compared to reader evaluation, using digital subtraction angiography (DSA) as standard of reference.

Materials and Methods Forty patients with peripheral vascular occlusive disease underwent both DSA and computed tomographic angiography. The vascular tree was divided into 6 segments from distal aorta to popliteal artery. Each district was evaluated for significant stenosis by one experienced vascular radiologist (on axial as well as 3D images) and by a semiautomated 3D software analysis, independently. Evaluation of the vessel evaluation was then repeated by a poorly experienced radiologist twice, first without 3D software analysis and then supported by 3D software analysis.

Results Both experienced radiologist and automated evaluations obtained high statistical results when compared to DSA. The analysis by poorly experienced radiologist obtained lower statistical results, which significantly improved when supported by 3D software analysis.

Conclusions Three-dimensional analysis software should be feasible to identify significant vascular stenoses and may help a poorly experienced radiologist to significantly improve diagnostic accuracy.

From the Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital, Catholic University, Rome, Italy.

Received for publication September 30, 2012; accepted January 10, 2013.

Reprints: Roberto Iezzi, MD, Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital, Catholic University, L.go A Gemelli 8, 00168 Rome, Italy (e-mail:;

There is no financial arrangement or other relationship that could be constructed as a conflict of interest for all authors.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.