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.

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