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At least 433 records · Page 24Linked to original sources
PubMed2004

Fluorescein angiography-guided indocyanine green angiography for the detection of feeder vessels in subfoveal choroidal neovascularization.

AIMS: To compare the newly devised fluorescein angiography (FA) - guided indocyanine green angiography (ICGA) with conventional ICGA for detecting feeder vessels in subfoveal choroidal neovascularization (CNV). METHODS: The detection of feeder vessels was attempted in 86 AMD patients with subfoveal CNV: 44 (age 70.4+/-4.5 years) underwent conventional ICGA (control group) and 42 (age 70.9+/-4.0 years) underwent an FA-guided ICGA (FA-guided group) using a double-detector scanning laser ophthalmoscope (SLO). In the control group, indocyanine green (ICG) was injected simultaneously with fluorescein. The patients were instructed to gaze forward localizing the fovea at the centre. In the FA-guided group, fluorescein sodium was injected a few minutes prior to ICG, and the patients were instructed to fixate in the appropriate direction by referring to the ongoing FA on the monitoring screen. In both groups, a 20 degrees visual angle was used to capture good images of feeder vessels in ICGA and, in case ICGA missed the first images of the entire CNV filling, an additional injection of ICG was given in the late phase to record the choroidal filling again. The overall detection rate, single-injection detection rate, double-injection rate and examination time were analysed using Fisher's direct exact probability test or Mann-Whitney's U-test. RESULTS: There was no significant difference in the overall detection of feeder vessels between the two groups (50% in the control group and 52.3% in the FA-guided group; P=0.49 with Fisher's direct exact probability test). However, in the FA-guided group, the single injection detection rate was significantly higher (45.1 and 15.9%, respectively; P<0.001 with Fisher's direct exact probability test); significantly less double injections were required (7.1 and 50%, respectively; P=0.003 with Fisher's direct exact probability test); and significantly shorter examination times were needed (9.6+/-3.7 and 14.1+/-6.8 min, respectively; P=0.02 with Mann-Whitney's U-test). CONCLUSION: FA-guided ICGA is effective for detecting feeder vessels of subfoveal CNV, minimizing the amount of ICG injected and the examination time compared to conventional ICGA.

Aged↗
PubMed2002

Contrast media nephropathy: intravenous CT angiography versus intraarterial digital subtraction angiography in renal artery stenosis: a prospective randomized trial.

BACKGROUND: Spiral computed tomographic angiography (CTA) is a noninvasive method to diagnose renal artery stenosis (RAS). In digital subtraction angiography (DSA), contrast media (CM) is injected directly into the renal artery; in CTA, a greater amount of CM is injected intravenously, potentially leading to an increased incidence of CM nephropathy. METHODS: We investigated 80 patients with suspected RAS randomized to either CTA or DSA prospectively. The following parameters were determined: serum creatinine level and single-shot inulin clearance for evaluation of renal function and urine alpha1-microglobulin and beta-N-acetyl-glucoseaminidase (beta-NAG) as markers for tubular toxicity. Data from 16 patients undergoing angioplasty in the same session were excluded. RESULTS: In the CTA and DSA groups, 163 +/- 13 and 104 +/- 56 mL of CM (mean +/- SD; P < 0.0001) were administered, respectively. Mean serum creatinine levels increased from 1.78 +/- 1.61 to 1.92 +/-1.73 mg/dL (157 +/- 142 to 170 +/- 153 micromol/L; P = 0.00001) in the CTA group and from 1.52 +/- 1.23 to 1.60 +/- 1.28 mg/dL (134 +/- 109 to 141 +/- 113 micromol/L; P = 0.01) in the DSA group. Mean inulin clearance decreased from 63 +/- 28 to 58 +/- 23 mL/min (P = 0.01) and 65 +/- 26 to 62 +/- 26 mL/min (P < 0.01), median beta-NAG levels increased from 4.6 to 6.0 U/g creatinine (P = not significant) and 2.5 to 8.0 U/g creatinine (P < 0.001), and median alpha1-microglobulin levels increased from 13 to 17 microg/g creatinine (P < 0.025) and 11 to 21 microg/g creatinine (P = not significant) in the CTA and DSA groups, respectively. CM nephropathy occurred in 3 of 33 patients in the CTA group and 2 of 31 patients in the DSA group. The increase in creatinine level was reversible in all patients within 7 days. CONCLUSION: On this study, CTA performed for the detection of RAS is not associated with an increased risk for CM nephropathy compared with intraarterial DSA despite a greater dose of CM.

Angiography, Digital Subtraction↗
PubMed1979

[Bilateral selective renal angiography--a procedure worth while? Report of the incidence of bilateral space-occupying lesions of the kidney in 2721 selective renal angiographies (author's transl)].

Since surgeons can save part of one kidney either by partial resection or reimplantation following "workbench" surgery, it has become increasingly important for the radiologist to demonstrate bilateral space-occupying lesions of the kidneys by bilateral selective angiography, magnification technique and computerized tomography of the kidneys. Fine-needle puncture of the kidney is an important additive technique to solve differential diagnostic problems of avascular, space-occupying renal lesions. Moreover it is a great comfort to the surgeon to know the appearance of both kidneys and may also modify the planned surgical procedure considerably. The incidence of 93 cases of bilateral space occupying lesions of the kidneys, diagnosed in 2721 selective renal angiographies over a period of 13 years, suggests that these entities are more frequent than previously thought.

Adult↗
PubMed2003

Evaluation of aortoiliac aneurysm before endovascular repair: comparison of contrast-enhanced magnetic resonance angiography with multidetector row computed tomographic angiography with an automated analysis software tool.

PURPOSE: The purpose of this study was to assess accuracy and reliability of a volumetric analysis of abdominal aneurysms on the basis of multidetector row computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) with a commercially available automated vessel analysis software program. MATERIALS AND METHODS: Twenty patients with abdominal aortic aneurysms underwent preoperative CTA and MRA before endovascular repair. Postdeployment CTA was performed in 15 of these 20 patients (75%). All preoperative CTA and MRA and postdeployment CTA data sets were analyzed with an automated software tool. The length of the stent grafts on postdeployment CTA was measured and compared with the true length of the primary component. Two readers independently evaluated 13 vessel parameters on preoperative CTA and MRA, which are considered to be important in planning stent graft deployment. RESULTS: With the automated analysis software tool, all measurements could be performed on either CTA or MRA data sets. There was no statistically significant difference between postdeployment measurements of stent graft length on CTA and the true dimensions of the implanted stent grafts. Interobserver agreement for all of the measurements with either CTA or MRA was good to excellent (interclass coefficient, 0.71 to 0.99) with only minimal mean differences of measured dimensions between both readers (range, -2.0 to +2.3 mm, Bland-Altman). Intermodality agreement between CTA and MRA was good to excellent (interclass coefficient, 0.62 to 0.98) with small mean differences of measured dimensions between both methods (range, -4.1 to +2.1 mm, Bland-Altman). CONCLUSION: Volumetric measurement with an automated analysis software tool allows a fast, precise, and reliable noninvasive preoperative determination of all aortic dimensions on the basis of either CTA or MRA data sets.

Aged↗
PubMed2003

Comparison of contrast-enhanced ct angiography and gadolinium-enhanced MR angiography in the detection of subsegmental-sized pulmonary embolism. An experimental study in a pig model.

PURPOSE: To compare contrast-enhanced CT angiography (CTA) and gadolinium-enhanced MR angiography (MRA) for the detection of subsegmental-sized pulmonary emboli in a pig model. MATERIAL AND METHODS: In 5 anesthetized pigs, 3-mm diameter embolic materials made of Konjac, a semisolid food, were introduced through the internal jugular vein into pulmonary arteries. After embolization, CTA and MRA images were obtained. Respiration was suspended during CTA and MRA image acquisition. Two readers reviewed the CTA and MRA images to detect emboli. The pigs were sacrificed, and sliced specimens of inflated lung served as the gold standard. RESULTS: Thirty-six emboli were detected within peripheral arteries. The sensitivity (and 95% confidence intervals) of CTA for the two readers were 57% (39-74%) and 66% (48-81%), and 88% (69-98%) and 92% (74-94%) for MRA. The specificity of CTA was 95% (91-97%) and 98% (96-99%), and that of MRA was 85% (74-93%) and 90% (80-96%). Interobserver agreement was higher for MRA (kappa 0.898) than CTA (kappa 0.574). CONCLUSION: For the detection of subsegmental pulmonary emboli, MRA was superior to CTA, with a higher sensitivity and interobserver agreement by demonstrating perfusion deficits.

Animals↗
PubMed2005

Comparison of synchrotron radiation angiography with conventional angiography for the diagnosis of in-stent restenosis after percutaneous transluminal coronary angioplasty.

AIMS: Synchrotron radiation angiography (SRA) is a novel tool for minimally invasive coronary artery imaging. The method uses subtraction of two images produced at energies bracketing the iodine K-edge after intravenous infusion of iodinated contrast agent. We investigated the accuracy of SRA for detecting in-stent restenosis (ISR). METHODS AND RESULTS: We recruited 57 men, 4-6 months after successful PTCA. We visualized the right coronary artery (RCA) in 27 patients with 36 stented segments [12 segments with ISR>50% by quantitative coronary angiography (QCA)], and the left anterior descending artery (LAD) in 30 patients with 37 stented segments (10 ISR). SRA and QCA were performed within 2 days of each other. Two experienced observers unaware of QCA data evaluated the SRA results. Image quality was good or excellent in most patients. Global sensitivity was 64%, specificity was 95%, and positive and negative predictive values were approximately 85%. Inter-observer kappa concordance coefficient was 0.86. False negatives involved short eccentric lesions and superimposed segments, most frequently of the LAD. False positives occurred in intermediate stenoses slightly overestimated by SRA. CONCLUSION: In men, this minimally invasive approach, using small radiation doses, detects significant ISR in the RCA, but the LAD poses difficulties because of superimposition with others structures.

Adult↗
PubMed1999

Global left ventricular cardiac function: comparison between magnetic resonance imaging, radionuclide angiography, and contrast angiography.

RATIONALE AND OBJECTIVES: Cardiac magnetic resonance imaging (MRI) has been shown to be a robust and noninvasive method to assess left ventricular (LV) cardiac function. This study sought to assess volumes and mass calculated with MRI using fast techniques for acquisition and postprocessing, and to compare results in terms of cost-effectiveness with those of radionuclide angiography (RNA) or contrast angiography (CA). METHODS: Thirty-five patients and 15 healthy volunteers were studied. All patients underwent an MRI examination during the same period that they underwent ventriculography (26 patients) or radiography (25 patients). From 7 to 11 short-axis slices were acquired with a breath-hold fast-gradient echo-segmented sequence from apex to base. Contours were drawn with an automated border detection software. RESULTS: Ejection fraction (EF) correlated well between modalities (r = 0.77, P<0.001, for MRI and RNA; r = 0.72, P< 0.001, for MRI and CA). CONCLUSIONS: Cardiac MRI is a fast and accurate technique for estimation of LV volumes, EF, and mass.

Adult↗
PubMed2006

Use of optical coherence tomography, fluorescein angiography and indocyanine green angiography in a screening clinic for wet age-related macular degeneration.

AIMS: To assess the utility of optical coherence tomography (OCT) in a nurse-led, fast-track clinic for new age-related macular degeneration (AMD) referrals, and to see how often indocyanine green angiography (ICGA) led to an additional diagnosis to that provided by fundus fluorescein angiography (FFA). METHOD: Retrospective audit of a consecutive series of 134 new patients referred with suspected wet AMD. When visual acuity was >or=6/60 an OCT was performed. If the OCT was consistent with "wet" AMD, the patient underwent simultaneous FFA/ICGA. The sensitivity and specificity of this clinic was calculated. The number of additional diagnoses made using ICGA was recorded. RESULTS: 23/134 (17.16%) patients had OCT only and were not subsequently found to have wet AMD. FFA/ICGA was performed in 111 patients, showing wet AMD in 90 (81%) patients. OCT as used in our clinic had a sensitivity of 1 and a specificity of 0.65 for detecting wet AMD. ICGA provided additional diagnoses in 19 (14.17%) patients. ICGA detected a specific vascular abnormality in 58% of the occult lesions. CONCLUSIONS: OCT proved to be an effective screening tool for wet AMD in this clinic, with excellent sensitivity and reasonable specificity. ICGA provided an additional diagnosis in a significant number of cases, but did not define a vascular abnormality in all occult cases.

Aged↗
PubMed1977

Application of longitudinal magnification effect to magnification stereoscopic angiography: a new method of cerebral angiography.

A new method of stereoscopic cerebral angiography has been developed which employs 2X radiographic magnification. In order to obtain the same depth perception in the object as with conventional contact stereoscopic angiography, one can made the x-ray exposures at two focal spot positions which are separated by only 1 inch (2.5 cm), whereas the contact technique requires a separation of 4 inches (10 cm). The smaller distance is possible because, with 2X magnification, the transverse detail in the object is magnified by a factor of two, but the longitudinal detail, which is related to the stereo effect, is magnified by a factor of four, due to the longitudinal magnification effect. The small focal spot separation results in advantages such as improved stereoscopic image detail, better image quality, and low radiation exposure to the patient.

Cerebral Angiography↗
PubMed2002

Gadolinium chelates in angiography and interventional radiology: a useful alternative to iodinated contrast media for angiography.

Gadolinium has physical properties that are well suited for radiographic imaging. Digital subtraction angiography with a gadolinium chelate as contrast medium can provide images of suitable quality for diagnosis and intervention. The overall safety profile of gadolinium-based contrast media is excellent. In particular, these contrast media are well tolerated in patients with renal insufficiency when administered intraarterially in doses of less than 0.3-0.4 mmol per kilogram body weight, with a decreased incidence of contrast medium-induced nephropathy, as compared with similar volumes of iodinated contrast material. The currently available formulations of gadolinium chelates can be injected safely into every arterial and venous structure. However, substantial data are lacking on the intraarterial use of gadolinium in patients with renal insufficiency, particularly at doses that exceed those routinely used in magnetic resonance angiography. Gadolinium chelates in appropriate volumes are useful alternative contrast media in selected high-risk patients undergoing angiographic studies.

Angiography↗
PubMed1995

Lower extremity spiral CT angiography versus catheter angiography.

Both catheter and spiral computed tomography (CT) angiography of the lower extremity vasculature were performed in six patients with clinically symptomatic peripheral vascular disease. Forty-eight arteries were studied and were independently evaluated for arterial stenoses and occlusions. Compared with catheter arteriography, CT angiography correctly depicted segmental occlusions and significant stenoses (> 50%) in 26 of 28 arteries, yielding a sensitivity of 92.9%, a specificity of 96.2%, and an overall accuracy of 95.5%.

Aged↗
PubMedDate not supplied

Sensitivity of computer assisted radionuclide angiography in transient ischemic attack and prolonged reversible ischemic neurological deficit. Comparison with findings in radiographic angiography and transmission computerized axial tomography.

Computer assisted radionuclide angiography (CARNA) with 99mTc-DTPA was employed to study 143 patients with transient ischemic attacks (TIA) and 79 patients with prolonged reversible ischemic neurologic deficit (PRIND). The results of CARNA were compared with findings from radiographic angiography (RGA) in 173 patients and with findings in transmission computerized axial tomography (T-CAT) in 154 patients. In patients with TIA, CARNA showed a hemispherical perfusion deficit in 74.8%, and with PRIND 87.3%. This deficit, determined as the relative difference between the involved and the non-involved hemisphere, was significantly (p less than 0.0025) greater in PRIND (minus 23%) than in TIA (minus 17%). Sensitivity of CARNA was independent of the interval from ictus to examination for more than 4 months. RGA in TIA revealed true positives in 82.0%, in PRIND it was 89.5%. T-CAT was positive in TIA in only 16.8% but in PRIND it was 64.4%. Combined sensitivities in TIA (92.4%) and in PRIND (94.0%) were highest with the combination of CARNA and RGA. However, in PRIND the combination of non-invasive methods (CARNA and T-CAT) revealed 93.2% positive findings. Combinations of these evaluation methods may be used to detect cerebrovascular disease in patients with such dysfunction.

Brain Ischemia↗
PubMed1987

Comparison of auscultation, continuous wave Doppler imaging, intravenous digital subtraction angiography and conventional angiography in diagnosis of carotid artery disease.

The reliability of auscultation, continuous wave (CW) Doppler imaging, and intravenous digital subtraction angiography (IV DSA) in the assessment of carotid artery disease has been evaluated in comparison with conventional angiography in 30 patients. With auscultation, specificity and sensitivity for internal carotid artery (ICA) stenosis of 50% or more were 81% and 67% respectively. CW Doppler imaging detected ICA stenosis of 50% or more with a sensitivity of 83% and a specificity of 92% and ICA occlusion with a sensitivity of 60%. The specificity of IV DSA was 95% and the sensitivity for ICA stenosis of 50% or more and ICA occlusion were 75% and 100% respectively. Combining CW Doppler and IV DSA findings raised sensitivity for ICA stenosis of 50% or more and ICA occlusion to 89% and 100% respectively and specificity to 95%. The combination of CW Doppler and IV DSA is a safe and accurate test battery in the detection and categorization of carotid disease.

Adult↗
PubMed2004

Multislice CT angiography: a practical guide to CT angiography in vascular imaging and intervention.

The development of multidetector CT (MDCT) has revolutionized CT angiography (CTA). Not only are new techniques now in the remit of CTA, but all the studies previously performed on single slice or helical CT can now be done with better resolution. The advantage of MDCT relevant to CTA is the ability to acquire high resolution, near isotropic data sets in a shorter acquisition time. Also important is the ability to achieve a longer scanning range in the arterial phase, which has seen the introduction of CTA of the peripheral arterial system. Image processing techniques have also progressed rapidly, with simplification of a previously cumbersome process. The high spatial resolution and relatively non-invasive nature make MDCT angiography a strong and serious competitor to established vascular imaging techniques. The implication is that traditional diagnostic pathways for evaluation of the vascular system have changed.

Angiography↗
PubMed2005

Effective doses in angiography and interventional radiology: calculation of conversion coefficients for angiography of the lower limbs.

The present study reports on investigations that we have performed to allow the calculation of effective doses (E) in interventional radiology. The use of published conversion tables might not allow sufficient guidance for the establishment of optimization strategies for procedures in interventional radiology. With the Monte Carlo N-Particle transport code (MCNP4B), conversion coefficients, linking dose-area product (DAP) measurements with E, are calculated for angiography of the lower limbs in six hospitals. The influence of various parameters on the calculation of these conversion coefficients is studied in a systematic way using the 2(n) factorial design. In this design the effect of different parameters and their pair-wise interactions on a certain variable is explored. In our study, the relevant parameters are tube potential, total filtration and field size and position. We concluded that the influence of radiation spectrum (kVp + filtration) is large and that the effect of field position and size is moderate, except when differences are observed in respect of the gonads. In that case, the variation in conversion coefficients is large. The results of this statistical analysis are then applied to the differences observed between the conversion coefficients, calculated for angiography of the lower limbs in the six hospitals. Recommendations for optimization of patient doses are given.

Adolescent↗
PubMed2006

Comparison of image quality, diagnostic confidence and interobserver variability in contrast enhanced MR angiography and 2D time of flight angiography in evaluation of carotid stenosis.

The aim of this study was to compare image quality, level of diagnostic confidence and interobserver agreement in assessment of carotid stenosis with contrast enhanced MR angiography (CE MRA) in comparison with 2D time of flight MR angiography (2D TOF MRA). 60 carotid arteries in 30 patients were examined by three observers. Image quality and diagnostic confidence were assessed on the basis of a visual analogue scale. Interobserver variability was assessed with the help of intraclass correlation coefficient. Median values on the visual analogue scale for image quality and diagnostic confidence were higher for CE MRA compared with 2D TOF MRA for all three observers. Higher intraclass correlation values were recorded for interobserver variability for CE MRA compared with 2D TOF MRA both for visual estimation of carotid stenosis as well as for measurement of carotid stenosis on the basis of North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) criteria. CE MRA provides better image quality, higher level of diagnostic confidence and more interobserver agreement compared with 2D TOF MRA.

Artifacts↗
PubMed2004

Multidetector CT angiography versus digital subtraction angiography for aortoiliac length measurements prior to endovascular AAA repair.

PURPOSE: To assess observer variation between calibrated-catheter digital subtraction angiography (DSA) and software-enhanced multidetector computed tomography angiography (CTA) in measuring vessel length prior to endovascular aortic aneurysm repair (EVAR). METHODS: Thirty patients (25 men; mean age 65 years, range 61-85) scheduled for EVAR underwent CTA in 4x2-mm collimation using advanced vessel analysis software. CTA measurements were performed twice by 2 blinded readers in random order with at least a 4-week interval between readings. Nine patients were found unsuitable for endovascular repair after the CTA, so DSA was performed in 21 patients for morphometric evaluation of the abdominal aorta and the iliac arteries. The following segments were measured: H1 (aneurysm neck), H2 (lower renal artery to distal aspect of the aneurysm), H3 (lower renal artery to aortic bifurcation), and H4a/H4b (lower renal artery to iliac bifurcations). Length measurements on DSA were made by (1) following the catheter path in the aortic lumen and (2) dividing tortuous vessel anatomy into segments and measuring each segment along an idealized centerline. Addition of the various segments allowed comparison with data obtained from CTA measurements. RESULTS: CTA was performed with good intraobserver agreement for all length parameters except H3 in reader 2 (p<0.05). While good interobserver agreement was demonstrated for CTA over long aortoiliac distances (H4a, H4b), higher interobserver agreement was obtained with DSA for shorter segments (H1, H2). Considerable differences were observed between CTA and DSA for the lengths H2 and H4b. CONCLUSIONS: CTA produces better intra and interobserver correlations in measuring vessel length than DSA. It has the potential to replace DSA as an imaging method before EVAR.

Aged↗
PubMed2006

Multislice computed tomographic angiography versus digital subtraction angiography in the follow-up of nitinol stents in the superficial femoral artery.

PURPOSE: To compare quantitative and qualitative parameters obtained from digital subtraction angiography (DSA) with multislice computed tomographic angiography (MSCTA) in the follow-up of superficial femoral artery (SFA) stents. METHODS: Thirteen patients who had SMART stents implanted in the SFA were examined systematically with DSA and MSCTA (16-row scanner) at 6 months. Quantitative analysis and morphological assessment were performed on DSA images by an independent core laboratory, while the MSCTA images were analyzed by 2 radiologists in consensus. DSA measurements included stent length, minimal lumen diameter and reference diameter at mid stent and 5 mm either side of the stent, and percentage of stenosis. For MSCTA images, lumen area and the minimum, maximum, and mean diameters were also recorded. The images were analyzed qualitatively for diameter stenosis (<50%, 50% to 70%, 71% to 99%, and occlusion), bends, fractures, and calcifications. RESULTS: There were no statistical differences between lengths of stented segments, diameter measurements, or percentages of stenosis from DSA and MSCTA images. The Bland-Altman method showed good agreement between the 2 methods of measurement. MSCTA detected in-stent proliferation with a diameter stenosis <50% in all 13 cases diagnosed on DSA (there was no stenosis >50%). There were no bends or stent fractures on either set of images. The agreement between DSA and MSCTA for the presence and grading of calcifications was moderate (kappa=0.5). CONCLUSION: MSCTA provided quantitative and qualitative data comparable with DSA in the analysis of SFA nitinol stents.

Aged↗