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PubMed2000

Gadolinium-enhanced magnetic resonance angiography, digital subtraction angiography and duplex of the iliac arteries compared with intra-arterial pressure gradient measurements.

PURPOSE: to compare gadolinium-enhanced magnetic resonance angiography (Gd-MRA), digital subtraction angiography (DSA) and duplex of the iliac arteries with intra-arterial pressure gradient measurement as the reference method. MATERIALS AND METHODS: Gd-MRA, DSA and duplex examinations of the iliac arteries were performed in 30 patients (60 arteries) with lower-limb arterial occlusive disease. In 29 arteries, pressure measurements were made (n=25) or the artery was found to be occluded on catheterisation (n=4). An aortofemoral peak systolic pressure gradient of 20 mmHg or more was regarded as haemodynamically significant. Stenoses with a diameter reduction of 50% or more on MRA or DSA, or an increase in peak systolic velocity greater than 150% (duplex) were considered significant. MRA examinations were evaluated by means of maximum intensity projections (MRA-MIP) and using source images and curved multiplanar reconstruction (MRA-MPR). RESULTS: the sensitivity (specificity) for a significant iliac artery stenosis were 81% (75%) for MRA-MIP, 76% (75%) for MRA-MPR, 86% (88%) for DSA, and 72% (88%) for duplex. CONCLUSION: with intra-arterial pressure measurements as the reference method, similar results were achieved with Gd-MRA, DSA and duplex concerning the detection of haemodynamically significant iliac artery stenoses. The use of source images and multiplanar reconstructions resulted in higher accuracy for the detection of occlusions.

Aged↗
PubMed1987

Digital subtraction angiography.

Digital Subtraction is a computerised radiological technique to demonstrate the vascular tree by removing unwanted background information and enhancing dilute contrast medium within the blood vessels. Contrast may be introduced intravenously or intra-arterially. The relative merits of these two methods, together with the advantages and limitations of the technique are discussed.

Angiography↗
PubMed1985

Comparison of nephroangiotomography, intravenous subtraction angiography and digital subtraction angiography in the diagnosis of renal hypertension.

Nephroangiotomography (NATG), intravenous subtraction angiography (ISA) and digital subtraction angiography (DSA) were compared with regard to their specificity and diagnostic value, their expenditure of time, equipment and staff as well as to their risk for the patients. The interpretation of NATG is inferior to ISA. The hitting quota of ISA and DSA is equal. The expenditure of time and staff for ISA is important, whereas the equipment for DSA is considerable; however, it has a wider use. In case of a low patient number, ISA delivers sufficient results in the diagnosis of renal hypertension with the advantage that it can also be performed in smaller radiological institutes.

Humans↗
PubMed1988

[Angiography in peripheral arterial occlusive disease. Comparison between large-format angiography, digital subtraction angiography and intermediate-format technic].

With peripheral venous injection of contrast medium, DSA serves to diagnose occlusive peripheral arterial disease in some 90% of cases. Indications for iv-DSA are occlusions and stenoses in the area of the iliac and femoral arteries, as well as in the proximal lower leg. Intraarterial DSA with fine needle is additionally indicated in some 10% of patients for examination of the distal lower leg arteries. In non-diagnostic DSA, conventional angiography using 100-mm technique may be performed with the same angiographic unit.

Angiography↗
PubMed1986

[New diagnostic possibilities of postmortam coronary angiography by digital subtraction angiography].

Postmortal digital subtraction angiography permits vessels filled with a contrast agent to be visualized selectively in a video film shot and the contrast agent flow to be observed directly in the coronary arteries. Compared to conventional static methods of postmortal coronary angiography, the judgment on the hemodynamic effects of stenosis and occlusion, as well as of collaterals and anastomosis, will be improved and therefore the diagnosis of acute coronary death. The diagnostic possibilities and advantages of DSA are demonstrated in two cases.

Adult↗
PubMed1985

Digital subtraction angiography (DSA): new perspectives in angiography.

Digital subtraction angiography (DSA) has strongly influenced angiographic procedures. Because it is less invasive it has increased the total number of angiographies in all places where it was introduced. The paper gives an introduction to the procedure explaining the roles of "digital" and "subtraction" in DSA. It is written from a technical point of view. The examples are taken from and with the DVI system.

Analog-Digital Conversion↗
PubMed2002

Peripheral vascular occlusive disease: evaluation with contrast-enhanced moving-bed MR angiography versus digital subtraction angiography in 106 patients.

OBJECTIVE: The purpose of our study was to compare contrast-enhanced moving-bed MR angiography and digital subtraction angiography in the evaluation of peripheral vascular occlusive disease. MATERIALS AND METHODS: This retrospective report includes 106 patients (45 women, 61 men) with known or suspected peripheral vascular occlusive disease who underwent MR angiography and intraarterial digital subtraction angiography of the peripheral arteries. MR angiography was performed on a 1.0-T unit using a moving-bed technique. Every leg was divided into 14 vascular segments, and severity of disease was scored in four categories. Digital subtraction angiography was the standard of reference. RESULTS: In the 106 patients, 2378 vessel segments were evaluated with both imaging modalities. In 2156 segments, MR angiography and digital subtraction angiography were concordant for stenosis classification, in 188 segments the two modalities differed in one category, and in 24 segments they differed in two categories. MR angiography achieved sensitivity and specificity of 96.7% and 95.8%, respectively, for differentiating nonsignificant from hemodynamically significant stenosis (kappa = 0.91). CONCLUSION: This study indicates that MR angiography is an accurate imaging modality in clinical practice. Our data support the concept that MR angiography can modify the diagnosis of suspected peripheral vascular occlusive disease.

Adult↗
PubMedDate not supplied

Diagnosis of hepatocellular carcinoma using digital subtraction imaging with the contrast agent, Levovist: comparison with helical CT, digital subtraction angiography, and US angiography.

Digital subtraction imaging was compared to helical CT, DSA, and US angiography to assess its usefulness in the evaluation of vascularity in hepatocellular carcinoma (HCC). Digital subtraction imaging using Levovist as the contrast agent was performed in 41 patients with 43 nodules (22 men and 19 women, aged 50 to 83 years; mean age, 65 years; mean maximum tumor diameter, 27.8+/-17.1 mm). Digital subtraction imaging showed hypervascular enhancement in 39 of the 43 nodules (91%). Helical CT showed areas of high attenuation in 40 of the 43 nodules (93%), while DSA and US angiography showed positive enhancement in 38 and 43 of the 43 nodules (88% and 100%), respectively. Digital subtraction imaging is useful for evaluating vascularity in HCC when the tumor can be visualized with non-enhanced US angiography.

Aged↗
PubMed2005

Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography.

BACKGROUND AND PURPOSE: Although digital subtraction angiography (DSA) provides excellent visualization of the intracranial vasculature, it has several limitations. Our purpose was to evaluate the ability of helical CT angiography (CTA) to help detect and quantify intracranial stenosis and occlusion compared with DSA and MR angiography (MRA). METHODS: Twenty-eight patients underwent CTA, DSA, and 3D time-of-flight (TOF) MRA for suspected cerebrovascular lesions. All three studies were performed within a 30-day period. Two readers blinded to prior estimated or calculated stenoses, patient history and clinical information examined 672 vessel segments. Lesions were categorized as normal (0-9%), mild (10-29%), moderate (30-69%), severe (70-99%), or occluded (no flow detected). DSA was the reference standard. Unblinded consensus readings were obtained for all discrepancies. RESULTS: A total of 115 diseased vessel segments were identified. After consensus interpretation, CTA revealed higher sensitivity than that of MRA for intracranial stenosis (98% versus 70%, P < .001) and occlusion (100% versus 87%, P = .02). CTA had a higher positive predictive value than that of MRA for both stenosis (93% versus 65%, P < .001) and occlusion (100% versus 59%, P < .001). CTA had a high interoperator reliability. In 6 of 28 patients (21%), all 6 with low-flow states in the posterior circulation, CTA was superior to DSA in detection of vessel patency. CONCLUSION: CTA has a higher sensitivity and positive predictive value than MRA and is recommended over TOF MRA for detection of intracranial stenosis and occlusion. CTA has a high interoperator reliability. CTA is superior to DSA in the evaluation of posterior circulation steno-occlusive disease when slow flow is present. CTA results had a significant effect on patient clinical management.

Adult↗
PubMed2004

Comparison of ultrasonography, CT angiography, and digital subtraction angiography in severe carotid stenoses.

Digital subtraction angiography (DSA) is considered to be the 'gold standard' for confirmation of severe (70-99%) stenoses of internal carotid arteries (ICAs). However, it is associated with a risk of complications. The aim of this study was to assess the accuracy of ultrasonography (US), computed tomographic angiography (CTA), and their combined use for the detection and quantification of severe carotid stenoses, when compared with DSA. Severe ICA stenoses were diagnosed by US in a set of 29 patients. All patients also underwent CTA and DSA. Sensitivity, specificity, positive (PPV), negative predictive values (NPV), and Pearson's correlation coefficient were used in the evaluation of the percentage of stenosis results. Homogeneity chi2 test was applied when assessing statistical significance. Severe stenosis was diagnosed in 34 ICAs. Two ICAs with uninterpretable CTA finding were excluded. The number of ICAs with stenoses 70-99%/<70%- US 32/0; CTA 29/3; US + CTA 29/3; DSA 24/8. Pearson's correlation coefficient - US 0.601; CTA 0.725; US + CTA 0.773. Sensitivity/specificity/PPV/NPV - US 1.0/0.75/0.75/xxx; CTA 1.0/0.844/0.828/1.0; US + CTA 1.0/0.844/0.828/1.0. Homogeneity chi2 test results - US, P = 0.002; CTA, P = 0.098; US + CTAG, P = 0.098. US in combination with CTA can be used for relatively secure diagnostics of severe ICA stenoses. Thus, invasive DSA can be avoided in a substantial number of patients.

Angiography, Digital Subtraction↗
PubMed1988

Preoperative diagnosis of ovarian malignancies with intravenous digital subtraction angiography.

Intravenous digital subtraction angiography was performed on 59 patients with ovarian tumors. Dilatation of the uterine artery and its ovarian branch was relatively frequent in both benign and malignant tumor groups, while dilation of the ovarian artery, and hypervascularity from the uterine artery or the ovarian artery were fairly specific to the malignant tumor group. These five abnormal vascular patterns were evaluated by a scoring system and approximately 75% of malignant and 87% of benign ovarian tumors were correctly diagnosed preoperatively by digital subtraction angiography alone. Intravenous digital subtraction angiography can be applied as an easy, safe, and valuable diagnostic method for ovarian malignancies and can replace conventional pelvic angiography.

Adult↗
PubMed2005

Contrast-enhanced MR angiography and digital subtraction angiography in living renal donors: diagnostic agreement, impact on decision making, and costs.

OBJECTIVE: The objective of our study was to evaluate the diagnostic agreement, the impact on decision making, and the costs of contrast-enhanced MR angiography and digital subtraction angiography in the workup of living renal donors. CONCLUSION: Contrast-enhanced MR angiography for the preoperative evaluation of renal donors is superior to digital subtraction angiography in revealing vascular anomalies and depicting parenchymal abnormalities and is less costly; furthermore, it does not lead to preoperative decisions that differ from those based on digital subtraction angiography. If contrast-enhanced MR angiography does not provide sufficient information to make a confident decision, an additional digital subtraction angiography examination should be performed.

Adult↗
PubMed1983

Pulmonary digital subtraction angiography.

Intravenous digital subtraction pulmonary angiography was performed in 220 patients. Of these, 206 had suspected pulmonary embolism. Our intravenous studies yielded images of diagnostic quality in 98% of cases. Compared to conventional pulmonary angiography, intravenous digital subtraction angiography (IV DSA) is safer, faster, and easier to perform. This technique is an acceptable substitute for routine pulmonary angiography in all patients with pulmonary embolism. Intravenous DSA is currently the procedure of choice for the evaluation of patients with suspected pulmonary embolism.

Angiography↗