Peripheral Pulmonary Arteries: How Far in the Lung Does Multi-Detector Row Spiral CT Allow Analysis?

PURPOSE: To analyze the influence of multi–detector row spiral computed tomography (CT) on identification of peripheral pulmonary arteries.

MATERIALS AND METHODS: Peripheral pulmonary arteries were analyzed on optimally opacified contrast material–enhanced spiral CT angiograms in 30 patients devoid of pleuroparenchymal disease who underwent scanning with multi–detector row CT (collimation, 4 × 1 mm; pitch, 1.7–2.0; scanning time, 0.5 second). Two series of scans were systematically generated from each data set, 1.25-mm-thick (group 1) and 3-mm-thick (group 2) sections, leading to the analysis of 600 segmental (20 arteries per patient), 1,200 subsegmental (40 arteries per patient), 2,400 fifth-order (80 arteries per patient), and 4,800 sixth-order (160 arteries per patient) pulmonary arteries in each group.

RESULTS: Multi–detector row CT with reconstructed scans of 1.25-mm-thick sections (group 1) allowed (a) analysis of a significantly higher percentage of subsegmental arteries (94% in group 1 vs 82% in group 2; P < .001) and (b) a significantly higher percentage of fifth- and sixth-order arteries, respectively, identified in 74% and 35% of cases in group 1 and 47% and 16% in group 2 (P < .001). The causes for inadequate depiction of subsegmental branches in group 1 were partial volume effect (43%), anatomic variants (39%), and cardiac (17%) and respiratory (1%) motion artifacts.

CONCLUSION: Multi–detector row CT with reconstructed scans of 1.25-mm-thick sections enables accurate analysis of peripheral pulmonary arteries down to the fifth order on spiral CT angiograms.

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Article History

Published in print: June 2001