ROLE OF CT ANGIOGRAPHY IN EVALUATING AORTO-FEMORAL STENOSIS COMPARED WITH DUPLEX ULTRASONOGRAPHY IN THE BANGLADESHI POPULATION
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Keywords
Aorto-femoral stenosis, Bland-Altman, Cohen Kappa, Computed tomography angiography, Duplex ultrasonography, Peripheral arterial disease
Abstract
Aorto-femoral stenosis is a critical manifestation of peripheral arterial disease. While Digital Subtraction Angiography (DSA) is the gold standard, it is invasive. Computed Tomography Angiography (CTA) and Duplex Ultrasonography (DUS) are widely used non-invasive alternatives. Objective: To compare the diagnostic efficacy of CTA and DUS for evaluating aorto-femoral stenosis in the Bangladeshi population. Methods: This comparative, multicenter study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Popular Diagnostic Center (Savar), Super Medical Hospital (Savar) and Enam Medical College Hospital (Savar), from July 2020 to December 2021. A purposive sample of 45 patients with clinical suspicion of aorto-femoral stenosis was enrolled. All participants underwent both CTA and DUS examinations. The collected data were analyzed using SPSS version 23.0. Results: Analysis of 45 patients revealed that CTA detected a higher prevalence of significant stenosis (68.9%) than DUS (57.8%). The inter-modality agreement was substantial (Cohen’s kappa=0.72). Bland-Altman analysis showed a mean bias of +5.2% stenosis for CTA. Using DUS as a reference, CTA demonstrated a sensitivity of 92.3% and a specificity of 84.2% for detecting hemodynamically significant lesions, with an overall diagnostic accuracy of 88.9%. Conclusion: In the Bangladeshi population, CTA demonstrates high diagnostic performance for aorto-femoral stenosis. This modality shows substantial agreement with DUS but offers superior sensitivity and comprehensive anatomical detail, supporting its role in definitive evaluation and procedural planning.
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Mohammad Ali Kabir
Medical Officer, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
A S M Shahidul Hossain
Consultant, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
Zeeren Sultana Deepa
Medical Officer, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
Nazrul Islam Mullah
Medical Officer, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.
Lt. Col. Sultana parvin
Classified Specialist in Radiology & Imaging, Department of Radiology & Imaging Combined Military Hospital (CMH), Dhaka
Mahmud Hasan Mostofa Kamal
Assistant professor, Department of Radiology & Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka.