Arterial imaging with computerized fluoroscopy.

Abstract

Computerized fluoroscopy (CF) allows visualization of any segment of the arterial vascular system with intravenous injection of small volumes of standard iodinated contrast media. Because it avoids the risk of arterial puncture and the need for hospitalization, this technique is safer and more economical than standard arteriography. Because of these advantages, CF is likely to expand the role of arteriography in the clinical management of vascular disease. Computerized arteriographic imaging requires an intravenous power injection of 40 to 60 cc of iodinated contrast media. Immediately after injection, six to ten fluoroscopic images (1/15 sec duration) are obtained at 1.5-sec intervals. The first image serves as a mask from which subsequent images are serially subtracted by means of a digital video image processor. The sequence of different images is contrast enhanced and stored on a video disk. Video images are converted to hard copy arteriography with a standard multiformat camera. Technical failures (<5%) may result from patient motion, inadequate peripheral venous access, or extravasation of contrast media. Nearly 600 computerized intravenous arteriograms have been performed in 240 patients with peripheral vascular disease. Qualitative com-parisons with standard arteriograms suggest a close correlation between these two imaging techniques. Computerized fluoroscopy allows the identification of atheromatous plaque ulceration, stenoses, occlusions, and aneurysms. This method has been used to visualize the aortic arch and its branches, the cervical and intracranial vessels, the abdominal aorta, and arteries of the extremities. Computerized fluoroscopy has great potential as a method for safe, simple diagnostic screening and assessment of the postoperative patient.