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PubMed1988

Demonstration of the ascending aorta in infective endocarditis by intravenous digital subtraction angiography.

Four patients with infective endocarditis were examined by digital subtraction angiography immediately before operation. In three a root abscess was suspected and the remaining patient was believed to have a false aneurysm at an infected aortic cannulation site. In all the cases digital subtraction angiography showed the structure in several projections and confirmed the presence of a cavity. Subsequent operation confirmed the site and nature of the lesions.

Adult↗
PubMed1990

Digital subtraction angiography in cerebrovascular diseases. Correlation of DSA with clinical findings.

Digital subtraction angiography (DSA) was performed in 100 patients with cerebrovascular diseases. The results of angiographic examination were compared with clinical findings on admission to and on discharge from hospital. The statistical evaluation was made on computers. Processing of anamnestic data revealed in the patients a large number of risk factors and other diseases, on average 3.68 per man and 3.96 per woman. 71% of the patients were examined on account of a relapse of some cerebrovascular disease. No relationship was found between the degree of the neurological deficit and clinical units on the angiographic finding. Clinically assumed arterial stenosis or occlusion was confirmed by DSA in 44.4%. On the other hand, in 57.9% of 38 affected subjects a stenotizing or obliterating process of the extracranial portion of the internal carotid was diagnosed in the absence of previous clinical suspicion. Of 76 patients with arteriosclerotic change in 56.6% the extracranial portion of the internal carotid was affected, incl. its bifurcation. Of 38 patients with stenosis or occlusion in 36.8% the affection was bilateral. Nine patients were indicated for operation, in another four endarterectomy of the internal carotid was done previously. DSA is a very useful examination method in patients with arteriosclerotic changes of the cerebral and cerebellar arteries. The risk for patients is, as compared with classical angiography, reduced while the obtained information on anatomical changes of the arterial wall is sufficient.

Adult↗
PubMed2002

Comparison of 2D and 3D digital subtraction angiography in evaluation of intracranial aneurysms.

BACKGROUND AND PURPOSE: Although digital subtraction angiography (DSA) is considered the criterion standard for depiction of intracranial aneurysms, it is often difficult to determine the relationship of overlapping vessels to aneurysms when using 2D DSA. We compared 2D and 3D DSA in evaluation of intracranial aneurysms. METHODS: Thirty-six consecutive patients with cerebral aneurysms underwent 2D and 3D DSA. After standard 2D DSA, rotational DSA was performed. Maximum intensity projection (MIP) and shaded surface display (SSD) images were created from the rotational DSA data sets. All images were assessed randomly for overall image quality, presence of aneurysm, presence of aneurysmal lobulation, visualization of aneurysmal neck, and relationship to adjacent vessels. Data analysis was conducted for 40 aneurysms treated by clip placement. RESULTS: One aneurysm that was not detected at 2D DSA was classified as uncertain on the basis of rotational DSA. All aneurysms were classified as probably or definitively present on the basis of MIP and SSD findings. Overall image quality of rotational DSA, MIP, and SSD was statistically inferior to that of the standard 2D DSA for visualization of distal arteries. However, MIP and SSD images were significantly superior to those of standard 2D DSA for all other evaluations. For detection of lobulation, SSD images were significantly superior to other images, and for visualization of aneurysmal neck and relationship to neighboring arteries, SSD images were significantly superior to those of rotational DSA. For evaluation of the relationship to neighboring arteries, MIP images were significantly superior to those of rotational DSA. CONCLUSION: Three-dimensional DSA, especially SSD, provided more detailed information for evaluating cerebral aneurysms than did standard 2D and rotational DSA.

Adult↗
PubMed1982

Digital subtraction angiography of the intracranial vascular system: comparative study in 55 patients.

Intracranial vessels were examined in 55 patients with both conventional selective catheterization and intravenous digital subtraction angiography using a prototype digital subtraction unit. In 65% of the patients, the digital subtraction angiogram was diagnostic, but the overall quality was inferior to conventional selective angiography. In 22%, the digital subtraction angiogram provided diagnostic information, but there was a significant chance of misinterpreting the results of the study. In 13% of cases, the subtraction angiogram was not diagnostic. As now developed, digital subtraction angiography can replace conventional cerebral angiography for preoperative evaluation of the juxtasellar carotid artery prior to transphenoidal surgery because the large intracerebral vessels are consistently well visualized with digital subtraction. The dural sinuses are better visualized with digital subtraction than with conventional angiography because with digital subtraction all the vessels of the brain are opacified, whereas with conventional angiography, there is a mixture of opacified and unopacified blood in the sinuses. Combined with computed tomography, digital subtraction angiography can replace conventional angiography for determining the preoperative extent and vascularity of tumors. It can be used for postoperative evaluation of aneurysms, arteriovenous malformations, extracranial to intracranial bypasses, and after the embolization of vascular lesions.

Adult↗
PubMed1985

Pulmonary digital subtraction angiography: a screening tool for vascular lung lesions.

Pulmonary digital subtraction angiography offers a further method of distinguishing vascular from avascular lesions in the lung. The computerised (digitised) recording allows versatility of data manipulation and post-processing and is of particular value in identifying a vascular component in complex lung masses. In the five cases described, digital subtraction angiography provided useful information; in three, it was the definitive diagnostic procedure.

Adult↗
PubMed2006

Comparison of intraarterial MR angiography at 3.0 T with X-ray digital subtraction angiography for detection of renal artery stenosis in swine.

PURPOSE: To compare the accuracy of catheter-directed intraarterial (IA) magnetic resonance (MR) angiography at 3.0 T with that of x-ray digital subtraction angiography (DSA) for the measurement of renal artery stenosis (RAS) in swine. MATERIALS AND METHODS: Unilateral hemodynamically significant RAS (>50%) was induced surgically in six pigs with use of reverse cable ties. One to two weeks after surgery, each pig underwent x-ray DSA and MR angiography before and after percutaneous transluminal balloon angioplasty (PTA). X-ray DSA was performed before and after PTA of RAS by injection of iodinated contrast agent through a 5-F multiple-side hole angiographic catheter placed in the abdominal aorta under fluoroscopic guidance. MR angiography of RAS was performed before and after PTA of RAS on a 3.0-T clinical MR imager with use of gadolinium-based contrast agent. MR angiography and DSA images were analyzed with the full width at half maximum method. Percent stenosis measurements between x-ray DSA and MR angiography were compared with a paired t test and were correlated with linear regression and Bland Altman analysis (alpha = 0.05). RESULTS: Six cases of RAS were induced and imaged successfully with DSA and MR angiography techniques before and after PTA. On x-ray DSA, median stenoses was 64% (95% CI 57%-80%) before PTA and 20% (95% CI 5%-32%) after PTA. Corresponding MR angiography median stenosis measurement was 69% (95% CI 58%-80%) before PTA and 26% (95% CI 16%-36%) after PTA. A paired t test comparison did not show a difference between DSA and MR angiography (P = .16). RAS measurements on MR angiography correlated closely (P < .01) with DSA measurements (r(2) = 0.92). CONCLUSION: In swine, the accuracy of catheter-directed IA MR angiography with use of a clinical 3.0-T MR imaging unit for the measurement of RAS was similar to that of conventional x-ray DSA.

Angiography, Digital Subtraction↗
PubMed1984

[Present status of digital subtraction angiography].

The present state of development of digital subtraction angiography can be characterised by the fact that, according to the results obtained so far, it can be most useful as a diagnostic method, depending on the clinical problems involved and on the condition of the patient, taking into consideration any possible history of patient allergy and the state of his cardiac and renal functions; if there are no contra-indications, the requisite contrast medium can be applied intravenously or intra-arterially. This method can also be used as a complement to conventional large-format angiography to obtain additional information; in other cases, it may not supply information in sufficient detail, thus requiring subsequent large-format angiography. Diagnostic safety of this method is more than 95% in all the essential indications, such as diagnosis of extracranial cerebrovascular disturbances of blood flow, detection of aneurysms of the aorta, evaluation of postoperative and post-treatment conditions in the vascular system, as well as renovascular hypertension. However, an essential prerequisite is the appropriate use of technical aids fitted to the equipment used for examination. Other essential requirements are the best possible positioning of the patient and his ability to cooperate.

Analog-Digital Conversion↗
PubMed2002

Pedal artery imaging--a comparison of selective digital subtraction angiography, contrast enhanced magnetic resonance angiography and duplex ultrasound.

OBJECTIVE: to evaluate selective digital subtraction angiography (DSA), contrast-enhanced magnetic resonance angiography (CE-MRA) and duplex ultrasound (duplex) in preoperative pedal artery imaging. MATERIAL AND METHODS: DSA, CE-MRA and duplex were studied prospectively in 37 patients suffering from critical leg ischaemia. Two radiologists independently reviewed both the CE-MRA and DSA images. The pedal vessels were scored on a scale from 0 to III (0=vessel not visualised, I=vessel faintly visualised, II=stenosis >50%, III=vessel without relevant stenosis). Duplex ultrasound was performed by an angiologist blind to both the DSA and MRA findings and the pedal arteries were scored 0-III according to their diameter. Each examiner named the pedal artery best suitable for bypass surgery. Agreement in artery assessment was expressed as kappa values. Patency of the bypass at 30 days was used as validation of the artery's suitability as the run-off vessel. RESULTS: interobserver agreement for DSA (weighted Kappa 0.63, CI 0.53-0.73 and CE-MRA (weighted kappa 0.60, CI 0.5-0.7) was moderate to substantial. CE-MRA depicted significantly more vascular segments than DSA (p congruent with 0.0001).In the prediction of the distal outflow vessel duplex and CE-MRA proved to be superior to DSA. CONCLUSION: because of the moderate inter-observer agreement it may be questionable to regard selective DSA as gold standard imaging procedure in preoperative pedal artery imaging. CE-MRA and duplex are very helpful in assessing the pedal artery morphology and should be used if selective DSA does not sufficiently depict the pedal vasculature.

Aged↗
PubMed1984

Digital subtraction angiography in infants and children with congenital heart disease.

Digital subtraction angiography was used as the sole imaging technique in 95 infants and children aged 13 hours to 16 years undergoing cardiac catheterisation for the investigation of congenital heart disease. Injections of diluted contrast medium were made selectively at central sites, and the images were obtained using continuous image intensification fluoroscopy at either 32.25 nC/kg/s (125 microR /s) or 129 nC/kg/s (500 microR /s). In all cases images adequate for diagnosis and management were obtained with appreciably less contrast medium and a lower radiation dose than in a comparable group of patients using conventional biplane cineangiography. Thus digital subtraction angiography is a viable alternative to biplane cineangiography for children with congenital heart disease.

Adolescent↗
PubMed1998

An algorithm for correction of distortion in stereotaxic digital subtraction angiography.

An algorithm for correction of the geometrical distortion in digital subtraction angiography (DSA) images was developed. Originally invented for 3D X-ray angiography, the algorithm was implemented in a computer program designed to fulfil the specific needs of stereotaxic DSA. The algorithm is based on transformation of an image of a grid from a distorted image back into its original pattern. The same transformation is then applied pixel-by-pixel to the angiographic images, which are acquired in direct conjunction with the grid image, without moving the gantry. The algorithm was tested in phantom studies and in the clinical situation with seven patients in ten examinations. Comparisons were made between co-ordinate determinations made on conventional full-size cut film and those performed on uncorrected and corrected DSA images, using 30- and 23-cm fields of view. With our method of measurement we could not shown any remaining geometric distortion in the corrected DSA images. This distortion correction can, if properly applied, be used for high-precision stereotaxic DSA.

Algorithms↗
PubMed1996

[3-D-TONE magnetic resonance angiography in the detection of intracranial aneurysms compared with digital subtraction angiography. A prospective study].

PURPOSE: To evaluate the efficiency and accuracy of the optimized 3-D-MT-TONE-magnetic resonance angiography (MRA) with that of intraarterial digital subtraction angiography (DSA) in the detection of intracranial aneurysms. MATERIAL AND METHODS: From March 1994 to March 1995 30 patients with 38 aneurysms were prospectively subjected to MRA as well as to DSA. Respiratory insufficient patients were excluded from MRA. RESULTS: The aneurysm size ranged from 3-50 mm with an average size of 9 mm. Correct diagnosis was done in 33 aneurysms (86.8%) in 26 of the patients. In 4 patients (13.3%) with 5 aneurysms, the blinded readers made an incorrect diagnosis due to degradation of image quality. One (2.6%) aneurysm was falsely described via MRA as well as via DSA. The sensitivity was 86.8%. In the control group of 30 patients three aneurysms were found, therefore the specificity was 90% and we could calculate a positive predictive value of 97.1%, a negative predictive value of 84.4% and a correct diagnosis of 90.1%. CONCLUSION: Our results show that MT-TONE-MRA is a useful non-invasive technique with improved vascular detail and vascular background for detection of intracranial aneurysm. Further technical improvements are necessary for better visualisation of pathological findings in the carotid siphon, where only 60% of the aneurysms could be clearly detected.

Adult↗
PubMed1990

[Venous digital subtraction angiography of the left ventricle in comparison with conventional angiography].

In 42 patients with coronary heart disease within a left heart catheterization by means of coronarography and conventional angiocardiography in each case before and after GTN digital subtraction angiographies of the left ventricle were performed with central venous injection of 20 ml visotrast with a flow of 16-18 ml/s. A DVI2-CV system of the firm Philips served as investigation device. In general between the angiocardiography and the digital subtraction angiographies the following results were obtained for EF 0.81, EDV 0.71, and ESV 0.88. When evaluating only the finally examined 22 patients the correlations improve for all parameters (EF: 0.89, EDV: 0.82, ESV: 0.90). Furthermore is was shown that the volumes are underestimated by 8-10%. The quantification of the regional movement of the wall according to the radial axis method did not results in any significant differences between the digital subtraction angiographies and the angiocardiography. The effects of GTN on the global and regional functional parameters appear somewhat more distinct in the digital subtraction angiographies than in the angiocardiography and are partly significant only in the first one. The influence of the experience of the investigator, the cardial state of the patient and other influential factors on the quality of the digital subtraction angiocardiographies are described and discussed. Therefore we regard the digital subtraction angiography as method of choice in indications to right heart catheterization without coronary angiography.

Adult↗
PubMed1991

[Combined digital subtraction angiography and cholangiography in assessing the spread of the tumor process in pancreatobiliary cancer].

The paper is concerned with comparative assessment of the efficacy of digital subtraction angiography and routine angiography in assessing tumor spreading in pancreatobiliary cancer. A combined method of digital subtraction angiography and cholangiography was developed and performed in 41 patients with pancreatobiliary cancer permitting maximum information on the topical location and spreading of a tumor process. The clinical importance of the obtained results permitted recommending simultaneous digital subtraction angiography and cholangiography in patients with hepatobiliary cancer.

Ampulla of Vater↗
PubMedDate not supplied

Digital subtraction angiography of glomus tympanicum and jugulare tumors.

Radiologic procedures used to evaluate patients with suspected glomus tumor have included plain skull radiography, temporal bone tomography, computed tomography, and cerebral angiography. Of these, only angiography has proven reliable as a screening procedure for small glomus tympanicum and jugulare tumors. Digital subtraction angiography was used as the initial examination for suspected paraganglioma in 14 patients. Intravenous digital subtraction angiography proved to be an acceptable screening tool for these highly vascular tumors. Also, intraarterial digital subtraction angiography proved very satisfactory for mapping of tumor blood supply, which greatly simplified preoperative embolization. Effectiveness of therapy was readily ascertained by serial follow-up intravenous digital subtraction angiography.

Adult↗
PubMed1999

Classification and digital subtraction angiography evaluation of carotid cavernous fistulas.

OBJECTIVE: To investigate the role of digital subtraction angiography (DSA) in evaluation of carotid cavernous fistulas, and to initiate a new classification for carotid cavernous fistula. METHODS: Cerebral angiography and selective external and internal carotid angiography were carried out in 56 patients who were classified into 5 types according to their hemodynamic features. RESULTS: The types were A (38 patients), B (4), C (10), D (2), and E (2). One of the 38 direct fistulas was located at C1 of the cavernous segment. Fistulas at C2 were observed in 10 patients, at C3 in 4, at C4 in 10 and at C5 in 5. The anterior communicating arteries were patent and well compensated in 33 of the 56 patients. The posterior communicating arteries were patent and well compensated in 39 patients. Both communicating arteries were well compensated in 31 patients. Fifty of the 56 patients were drained by ophthalmic veins, 47 by inferior petrous sinuses, 18 by cortical veins, and 8 to the posterior fossa region. CONCLUSIONS: Digital subtraction angiography was helpful in localization of the rents in carotid cavernous fistulas, in evaluation of function of Willis circles and provided valuable information for treatment of carotid cavernous fistulas. Carotid cavernous fistulas were divided into 5 categories: type A, B, C, D and E, among which type E was not previously described elsewhere.

Adolescent↗
PubMed1990

Intravascular ultrasonography versus digital subtraction angiography: a human in vivo comparison of vessel size and morphology.

The accuracy of catheter-based intravascular ultrasonography to define luminal size in humans in vivo and its sensitivity to describe lesion morphology have not been previously reported. Vessel diameter, cross-sectional area and lesion characteristics assessed by digital subtraction angiography and intravascular ultrasonography (20 MHz) were compared in 86 human arterial segments. The same arterial segments were imaged and analyzed by digital subtraction angiography and intravascular ultrasonography at 49 femoral, 3 renal, 5 iliac, 7 pulmonary and 22 aortic sites. Digital subtraction angiographic diameter and area were determined geometrically by an automated algorithm. Intravascular ultrasonographic diameter and area were determined by planimetry. Linear correlation for diameter by the two techniques was 0.97, standard error of the estimate (SEE) = 1.83 mm, and for cross-sectional area it was 0.95, SEE = 0.65 cm2. Intravascular ultrasonography identified 24 sites in which plaque was present; 11 (46%) of these segments appeared normal by digital subtraction angiography. Conversely, digital subtraction angiography demonstrated irregularities in 18 segments of which 5 (28%) appeared normal by intravascular ultrasonography. These data indicate an excellent correlation between intravascular ultrasonography and digital subtraction angiography for in vivo assessment of human arterial dimensions in normal and minimally diseased segments. However, intravascular ultrasonography is more likely to identify atherosclerotic plaque that may be angiographically "silent."

Angiography, Digital Subtraction↗
PubMedDate not supplied

Intraarterial digital subtraction angiography in bronchogenic carcinoma treated with bronchial artery infusion.

Intraarterial digital subtraction angiography (IADSA) has been used with advantage for control of the results of bronchial artery infusion of drugs for primarily unresectable bronchogenic carcinoma. The IADSA has been performed as road mapping prior to therapy. Drug treatment has been performed with four different regimes, depending on tumour type. Debulking and in some cases complete healing are the results, which are superior to other reported treatments.

Aged↗