Computed tomographic quantification of gluteal muscles perfusion

Objective . Analyze sensitivity and specificity of perfusion computed tomography in diagnostics of occlusive disease of the supplying gluteal muscles arteries. Material and methods . In 138 patients with aortoiliac aneurysmatic and/or occlusive disease, lower extremity arterial disease and long-term period after reconstructive interventions follow up, computed tomographic angiography with perfusion assessment was performed. Results . Mean blood flow velocity indices in 276 gluteal muscles were divided into 3 groups: Group 1 (n = 82) – with arterial stenosis >50% or occlusion, leading to blood flow reduction in both gluteal artery and deep femoral artery basins; Group 2 (n = 105) – with blood flow reduction only in the gluteal arteries; Group 3 (n = 89) – without blood flow disorders in the gluteal arteries. The median of the mean blood flow velocity in the gluteus maximus and medius in the Group 1 was 7.5 and 6.1 ml/100 g/min, in Group was 8.1 and 5.7 ml/100 g/min, and in Group 3 was 10.0 and 7.9 ml/100 g/min, respectively. The mean blood flow velocity was statistically significantly lower in the gluteal muscles of Group 1 and 2 in comparison to Group 3, as well as in the gluteus maximus with the presence of symptoms of proximal claudication in comparison with its absence (8.0 vs 8.3 ml/100 g/min, respectively). The sensitivity and specificity of the method in diagnosing occlusive disease of the supplying arteries were 73% and 53%, respectively, at the level of the mean gluteus maximus blood flow velocity ≤ 9.8 mL/100 g/min. Conclusion . Perfusion computed tomography allows us to assess the severity of regional hypoperfusion of the gluteal muscles at rest.