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Results for “Angiography, Digital Subtraction”

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PubMed1982

Carotid artery surgery based on digital subtraction angiography.

This study shows that digital subtraction angiography provides the morphologic criteria necessary for surgical intervention in most patients with carotid atheroma. Digital subtraction angiography provides a safe means of studying patients, with an overall sensitivity of 96 percent and specificity of 86 percent. Radiopaque casts of the operative specimen have been used as the gold standard, providing a suitable means of comparing the findings on digital subtraction angiography with the operative findings. Failure to obtain visualization of the vessels with biplanar views required conventional angiography to properly evaluate the vessels in 12 percent of patients. This technique represents a major advance in the study of carotid artery disease which may replace many of the current imaging techniques.

Arteriosclerosis↗

PubMed1999

Maximum internal carotid arterial stenosis: assessment with rotational angiography versus conventional intraarterial digital subtraction angiography.

PURPOSE: To assess how often rotational angiography depicts more severe internal carotid arterial stenosis compared with conventional intraarterial digital subtraction angiography (DSA) in two or three projections and how frequently this factor may affect patient treatment. MATERIALS AND METHODS: Rotational angiography (16 or 32 projections) was performed in addition to DSA in 47 stenotic internal carotid arteries (ICAs) in 38 symptomatic patients. ICA stenosis was measured independently at DSA and at rotational angiography with North American Symptomatic Carotid Endarterectomy Trial criteria. The degree of stenosis was categorized as 0%-29%, 30%-49%, 50%-69%, or 70%-99%. RESULTS: In three ICAs, rotational angiography was nondiagnostic. In 28 of the remaining 44 ICAs, the degree of stenosis was categorized similarly with DSA and rotational angiography, whereas with rotational angiography, 15 ICAs were classified one category higher and one ICA was classified two categories higher, owing to the increased number of projections available. Seventy percent to 99% stenosis was demonstrated in 18 ICAs with DSA and in 25 ICAs with rotational angiography. Thus, rotational angiography could have facilitated a change in the optimal treatment (from nonsurgical treatment to carotid arterial endarterectomy) in seven ICAs. CONCLUSION: Compared with DSA in two or three projections, rotational angiography frequently depicts more severe ICA stenosis. This indicates a limitation of DSA in depicting the maximum ICA stenosis.

Aged↗

PubMed1997

Common carotid artery bifurcation: preliminary results of CT angiography and color-coded duplex sonography compared with digital subtraction angiography.

OBJECTIVE: The purpose of this study was to compare the abilities of color-coded duplex sonography, CT angiography, and selective digital subtraction angiography to reveal disease requiring surgery in patients with occlusive disease of the carotid bifurcation. MATERIALS AND METHODS: Fifty-six carotid arteries in 28 patients who had 48 carotid stenoses and symptomatic cerebrovascular disease were prospectively studied by selective digital subtraction angiography, color-coded duplex sonography, and CT angiography. CT data were displayed in maximum intensity projection. The degree of stenoses revealed were graded as mild, moderate, severe, and occluded according to North American Symptomatic Carotid Endarterectomy Trial criteria. The results of CT angiography and color-coded duplex sonography were correlated with the gold standard of digital subtraction angiography. RESULTS: Grading of stenoses on CT angiography agreed with grading of stenoses on digital subtraction angiography in 89% of cases. All high-grade stenoses and occlusions revealed on CT angiography were correctly interpreted by all observers. For stenoses revealed by color-coded duplex sonography and digital subtraction angiography, observers' agreement was 75%. Two severe stenoses were incorrectly graded as occluded by the interpreter of the color-coded duplex sonograms. Also, one occluded carotid artery was misdiagnosed as moderate stenosis. CONCLUSION: Our results indicate that CT angiography is superior to color-coded duplex sonography for evaluating carotid disease and determining disease requiring surgery. CT angiography warrants further investigation in a larger group of patients.

Angiography, Digital Subtraction↗

PubMed1987

[Imaging of aortocoronary bypasses with intravenous digital subtraction angiography].

We examined 24 patients with 52 coronary bypass grafts, an average of 18 months after their respective operations. During the course of 1 week, a coronary angiography and a digital subtraction angiography (DSA) incorporating an intravenous injection of contrast medium were performed. Conventional coronary angiograms showed 40 bypasses as being open, ten as being occluded, and two could not be displayed at all. With the aid of digital angiography, 50 out of 52 bypasses could be classified as either open or occluded. In 44 out of 52 bypasses, DSA and coronary angiogram results were identical. Using DSA, three out of ten angiographically occluded bypasses were falsely diagnosed as being open and three out of 40 open bypasses as occluded. Two bypasses could not be interpreted due to poor picture quality. In the diagnosis "open bypass" the degree of both sensitivity and specificity subsequently amounted to 92.5%, and 70% in the diagnosis "occluded bypass". The distal part of the bypasses, as well as the proximal and distal part of the anastomoses, could not be evaluated for the most part. Furthermore, on account of the comparatively inferior quality of the pictures, detection of bypass stenosis is not reliable using digital subtraction angiography. Intravenous digital subtraction angiography may therefore serve as a screening method in the evaluation of coronary bypass grafts.

Coronary Angiography↗

PubMed2001

A review of image quality and dose issues in digital fluorography and digital subtraction angiography.

This paper addresses image quality and dose issues in Digital Fluorography (DF) and Digital Subtraction Angiography (DSA), commencing with a brief review of methods and protocols for image quality assessment in DF and DSA. The relative scarcity of standards and test protocols for unsubtracted DF is highlighted. Pooled results from a large number of quality assurance tests are then used to illustrate trends in the choice of radiation dose per image currently employed in typical DF and DSA work. It is concluded that, although relatively high doses per image may be justified in terms of image quality improvement for DSA, there is little justification for the large range of exposures used in DF for nominally identical examinations. It is argued that the use of high doses per image in DF would not be expected to offer an advantage in terms of image signal-to-noise ratio.

Angiography, Digital Subtraction↗

PubMed2006

Visualization of intrarenal vessels by 3.0-T MR angiography in comparison with digital subtraction angiography using renal specimens.

BACKGROUND: MRI at 3.0 T enables high-spatial resolution for renal MR angiography. OBJECTIVE: Evaluation of an arterial tree model in animal kidney specimens with comparison of digital subtraction angiography (DSA) and high-field MRI to find out the maximum spatial resolution of intrarenal vessels. It was considered that objective quantitation of angiogram quality could be achieved. MATERIALS AND METHODS: A total of 27 pig kidney specimens were examined by MR angiography (flash 3D) using a 3.0-T scanner (TRIO; Siemens, Erlangen, Germany) with an eight-channel head coil and a voxel size of 0.9x0.9x1.1 mm in the early arterial phase after implantation of a 4F catheter in the renal artery. DSA (Integris, Philips, Best, The Netherlands) was performed immediately after the MRI. With the help of semiautomated segmentation, all vessels were marked for comparison of the vessel trees. The Wilcoxon rank test was used for statistical evaluation of vessel numbers and branching depths. RESULTS: Objective comparison between DSA and MR angiography was achieved. High-field MR angiography had the ability to depict vessels up to the seventh branching on average. Significant differences in vessel delineation and counts were found from the fifth level of intrarenal branching onwards with DSA showing an advantage. CONCLUSION: High-field MRI has great potential in the detection of intrarenal arteries and is comparable to DSA in visualization of the central intrarenal vessel tree.

Angiography, Digital Subtraction↗

PubMed1998

Prospective analysis of complications of catheter cerebral angiography in the digital subtraction angiography and magnetic resonance era.

Permanent and temporary neurological complications of catheter cerebral angiography were prospectively evaluated in 500 consecutive diagnostic cerebral angiographic procedures, 268 performed on 213 males and 232 on 175 females. Complications were divided into permanent (> 1 week), reversible (< or = 1 week, > 24 hours), and temporary (< or = 24 hours). There were four permanent (0.8%), one reversible (0.2%), and nine temporary neurological complications (1.8%). There was no death. With the correct selection of patients, catheter cerebral angiography is considered to be safe with acceptable rates of complications.

Aged↗

PubMed2003

Preoperative evaluation of hilar cholangiocarcinoma with contrast-enhanced three-dimensional fast imaging with steady-state precession magnetic resonance angiography: comparison with intraarterial digital subtraction angiography.

We sought to evaluate the image quality of double-dose, contrast-enhanced 3D fast imaging with steady-state precession (FISP) magnetic resonance (MR) angiography in patients with hilar cholangiocarcinoma, and to compare its efficacy with intraarterial digital subtraction angiography (DSA). Thirty-six patients were studied to determine the visibility of the hepatic artery and portal vein with contrast-enhanced MR angiography. Determination of hepatic arterial and/or portal invasion from cholangiocarcinoma was compared between MR angiography and DSA as well. 0.2 mmol/kg gadolinium chelates were administrated at a rate of 4 ml/s. The hepatic artery was diagnostically visible in 28 patients (78%); the portal vein, in 34 patients (94%). The sensitivities, specificities, and accuracies in distinguishing arterial invasion, were 58%, 93%, and 89%, respectively, with MR angiography; 75%, 99%, and 96%, respectively, with DSA. In distinguishing portal venous invasion, these were 78%, 91%, and 89%, respectively, with MR angiography; 78%, 92%, and 90%, respectively, with DSA. There were no significant differences between imaging methods ( p >.05); however, DSA was superior in specificity regarding hepatic arterial invasion ( p =.0143). The data presented here indicate that noninvasive contrast-enhanced 3D FISP MR angiography has the potential to replace DSA in the preoperative evaluation of hilar cholangiocarcinoma.

Adult↗

PubMedDate not supplied

Stereoscopic digital subtraction angiography in neuroradiologic assessment.

Digital subtraction angiography (DSA) with stereoscopic imaging was performed in 40 patients for evaluation of a variety of cerebrospinal disorders. It was facilitated by a C-arm mounted x-ray tube and imaging chain with 7 degrees angulation between image pairs. Stereoscopic digital imaging proved particularly useful in the preoperative assessment of aneurysms, arteriovenous malformations, and primary and metastatic tumors. The technique was also found to be useful as a real-time adjunct to therapeutic radiographic procedures, as an aid in stereotaxic procedures, and in follow-up of postsurgical patients. Although the intravenous route was occasionally used, especially in postoperative follow-up of aneurysms, the procedure was most often carried out via an intraarterial approach. Stereoscopy was useful in supplying depth information regarding the relations between lesions and surrounding normal and abnormal vasculature. This technique combines the demonstrated advantages of intraarterial DSA with the unique advantage of stereoscopic imaging to demonstrate three-dimensional detail, thus contributing significantly to diagnostic confidence. Disadvantages are discussed. Further refinements in the equipment are expected: generation of stereo images with one injection, thus increasing procedure efficiency and patient safety; a video stereoscopic viewing unit; and the ability to obtain precise measurements via computer of depth, position, distance between, and true size of objects.

Adolescent↗

PubMed1984

Digital subtraction angiography in extremity trauma.

Digital subtraction angiography (DSA) may have considerable impact on the work-up of patients who have suffered blunt or penetrating trauma. The angiographic evaluation of vascular injuries (e.g., arteriovenous fistulae, pseudoaneurysms, hemorrhage) can be accomplished rapidly and with minimal catheter use and manipulation, which is particularly important for those critically ill patients who have significant immobility because of multiple fractures. We retrospectively reviewed the digital subtraction angiograms in 50 consecutive cases of extremity trauma. The quality of the images in 44 of these permitted a confident diagnosis, the accuracy of which was confirmed by surgical or clinical follow-up. One false-positive and three false-negative examinations for small muscle bleeders were discovered, but none of these was considered clinically significant. DSA reduces the time required to perform the procedure, the amount of contrast material injected, patient discomfort, and film cost. Its major disadvantage is the limited field size of the image intensifier.

Angiography↗

PubMedDate not supplied

AUR Memorial Award. Determinants of contrast enhancement for intravenous digital subtraction angiography.

Mask mode intravenous digital subtraction angiography (IV-DSA) image quality is directly dependent on the arterial time-concentration curve peak and width produced by contrast media. Curves with high peak iodine concentration produce excellent difference images. Curves that are narrow appear and disappear quickly and minimize movement artifacts. Using a noninvasive x-ray technique for quantitative measurement of contrast media time-concentration curve parameters and cardiac output, three experimental data bases were analyzed. From the analyses, equations defining curve peak and width were derived and validated. Width is proportional to central blood volume and inversely proportional to cardiac output. Peak is proportional to the quantity of contrast media injected and inversely proportional to central blood volume. Hypertonic contrast media increases central blood volume and lowers curve peak. Optimal contrast media for IV-DSA is low in concentration and high in volume. In addition, low concentration contrast media may be more comfortable for the patient causing fewer motion artifacts.

Angiography↗

PubMed1984

Pediatric digital subtraction angiography.

Experience with intravenous digital subtraction angiography (DSA) in infants and children is limited, although its relative ease of performance, low complication rate, and diagnostic accuracy indicate great potential. We performed 87 DSA examinations (74 patients) and obtained sufficient detail to facilitate diagnosis in most cases. The major problems of patient movement and overlapping vessels can be minimized by judicious use of sedation and strict attention to technique. Exposure of patients to radiation has not been a limiting factor since our system uses low exposure factors (2-38 mR [.51-9.76 mu C/kg]/frame). Our results demonstrate that DSA has wide applicability to many organ systems and is especially useful in intracranial disease and for preoperative evaluation of neoplasms. More specific indications for its use in children must await further correlative studies.

Adolescent↗

PubMed1985

Digital subtraction angiography apparatus.

An inexpensive digital subtraction angiography (DSA) apparatus that can perform live subtraction, processed subtraction, and road mapping is described. The apparatus can be used in any standard x-ray room with fluoroscopic capability, with a simple connection to the existing TV chain. It is especially useful in therapeutic neuroangiography.

Angiography↗

PubMed1983

Digital subtraction angiography of aortic dissection.

Digital subtraction angiography (DSA) was used to study six patients with aortic dissection, five of whom had undergone surgical repair. One patient had both pre- and postoperative evaluations. DSA with intravenous contrast administration is a relatively noninvasive procedure that provides diagnostic images in projection format allowing assessment of the extent of aortic dissection and involvement of important aortic branches. Postacquisition reprocessing techniques unique to DSA optimize the imaging information regarding flow dynamics of the true and false channels.

Aortic Dissection↗

PubMed1986

Incidence of fibrillation with isotonic contrast media for intra-arterial coronary digital subtraction angiography.

Intra-arterial digital subtraction angiography (DSA) can produce coronary artery opacification with isotonic contrast media. In this study we have examined the importance of electrolyte composition in isotonic formulations on the incidence of fibrillation. Right coronary injections of media were made for 25 s in anesthetized dogs. Isotonic meglumine diatrizoate and iohexol produced fibrillation in more than 68% of the injections, while sodium diatrizoate, saline, meglumine/sodium ioxaglate and iohexol with added sodium diatrizoate never produced fibrillation. These animal studies demonstrate a significantly higher risk of fibrillation (p less than 0.005) with isotonic nonionic and ionic media not containing sodium ions.

Angiography↗

PubMed1986

[Myocardial perfusion imaging by digital subtraction angiography].

Several methods of digital subtraction angiography (DSA) were compared to determine which could better visualize regional myocardial perfusion using coronary angiography in seven patients with myocardial infarction, two with angina pectoris and five with normal coronary arteries. Satisfactory DSA was judged to be achieved if the shape of the heart on the mask film was identical to that on the live film and if both films were exactly superimposed. To obtain an identical mask film in the shape of each live film, both films were selected from the following three phases of the cardiac cycle; at the R wave of the electrocardiogram, 100 msec before the R wave, and 200 msec before the R wave. The last two were superior for obtaining mask and live films which were similar in shape, because the cardiac motion in these phases was relatively small. Using these mask and live films, DSA was performed either with the continuous image mode (CI mode) or the time interval difference mode (TID mode). The overall perfusion of contrast medium through the artery to the vein was adequately visualized using the CI mode. Passage of contrast medium through the artery, capillary and vein was visualized at each phase using TID mode. Subtracted images were displayed and photographed, and the density of the contrast medium was adequate to display contour lines as in a relief map. Using this DSA, it was found that regional perfusion of the contrast medium was not always uniform in normal subjects, depending on the typography of the coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗

PubMed1985

[State of the art of digital subtraction angiography in diagnostic angiology].

Digital subtraction angiography (DSA) has become a widely accepted method which has decreased the risks of angiographic investigations. Intravenous DSA is the preferred method for screening investigations of carotid and renal arteries and in postsurgical control studies. Intraarterial DSA will be indicated if a detail information is required. The technical principles of time and energy subtraction will be explained, the different methods of contrast medium application will be discussed.

Angiography↗

PubMed2002

Arteriovenous angiomas in pictures of digital subtractional angiography (DSA).

The value of digital subtractional angiography (DSA) was presented in the material of 16 arteriovenous angiomas found in the group of 591 angiographies of cerebral arteries. Visualisation of arterial supplying vessels, vascular mass, nucleus and draining vessels was analyzed. Angiograms were correlated with CT contrast sections to reconstruct coexisting intracerebral and subarachnoid hemorrhages. The degree of visualization of mass effect in the two examinations was compared. There was emphasized the role of angiographic demonstration of the sucking effect of angiomas in the so-called stealing syndromes.

Angiography, Digital Subtraction↗