Combined morphological and hemodynamic assessment from time- resolved CT Angiography in patients suffering from Peripheral Arterial Disease

Lower extremity Peripheral Arterial Disease (PAD) is a disease that causes a partial or complete obstruction in the leg arteries. This obstruction reduces the blood supply to the surrounding muscles and feet which can result in tissue death and amputation. The current examinations of the below-the-knee arteries are challenging and provide insuficient information. Therefore, there is a need for a more detailed diagnosis in order to enable patient-specific treatment.

Since the blood flow in the arteries is decreased, we believe that calculating the blood flow could provide us with information regarding these obstructions. Local irregularities in blood velocity or differences in blood velocity between both legs could indicate an obstruction. Depending on the size of these irregularities, the severity of the obstruction could be obtained. In addition, we also want to examine the direct effect of the obstructed arteries on the surrounding muscles by measuring the blood circulation in these muscles. This would be an added value of the diagnosis.

We will obtain this dynamic information by acquiring multiple CT scans after each other over a same area of interest. By injecting a contrast agent prior to the CT acquisition, the result will be a stop-motion movie in which we can see the contrast agent flow through the arteries. To obtain dynamic parameters such as the velocity, we will apply multiple image processing techniques.