Comparative Evaluation of Multidetector Computed Tomography Angiography & Color Doppler Ultrasonography in Lower Limb Peripheral Arterial Disease

Abstract

Introduction: Peripheral arterial disease (PAD) is a common vascular disorder that necessitates precise imaging for accurate diagnosis and effective management. Among the available non-invasive imaging techniques, Color Doppler Ultrasonography (CDUS) and Multidetector Computed Tomography Angiography (MDCTA) are widely utilized, each offering unique benefits in vascular assessment.

Aims & Objectives: This study aimed to evaluate and compare the diagnostic performance of CDUS and MDCTA in patients with lower limb PAD, focusing on their sensitivity, specificity, overall accuracy in grading arterial stenosis.

Materials & Methods: A hospital-based descriptive cross-sectional study was carried out on 48 patients, accounting for 96 lower limbs, all clinically suspected of having PAD. Each participant underwent both CDUS and MDCTA examinations. Arterial stenosis was categorized into five groups: normal, mild (≤50%), moderate (50–70%), severe (≥70%), and complete occlusion. Statistical analysis was conducted using IBM SPSS version 26, with a p-value of less than 0.05 considered statistically significant.

Results: Most participants were male (72.9%), with the highest proportion falling within the 61–70 years age group (39.6%). Claudication emerged as the most frequent presenting complaint (44.8%). CDUS demonstrated excellent sensitivity (100%) and high specificity (89.7%) when compared with MDCTA, achieving an overall diagnostic accuracy of 93.6%. There was near-perfect agreement between the two modalities (κ = 0.86), along with strong diagnostic performance (AUC = 0.93). However, CDUS showed a tendency to overestimate stenosis in infrapopliteal segments, where specificity was relatively reduced, while MDCTA provided better visualization of distal vessels.

Conclusion: CDUS serves as a highly sensitive, non-invasive screening tool, especially effective for proximal arterial segments. MDCTA remains a reliable reference standard, offering superior anatomical detail and precise stenosis grading necessary for treatment planning. A combined imaging approach enhances diagnostic accuracy, particularly for evaluating distal arterial involvement.

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