Abstract
Central cardiovascular anatomy and function have been evaluated with intravenous digital subtraction angiography (DSA). The subtraction techniques used for studying the left ventricle (LV) were mask mode, time interval difference and functional subtraction. Aside from contrast enhancement, a major use of digital fluoroscopy for cardiac applications has been computer-assisted quantitative analysis of LV dimensions and function.
Left ventricular volumes and wall thickness determined from DSA studies have correlated closely with direct left ventriculograms and sonocardiometry measurements in patients and animals, respectively. Measurements of segmental LV contraction with DSA correlated closely with direct left ventriculography in normal patients and patients with coronary artery disease. The sensitivity of intravenous DSA for detecting significant coronary artery disease was increased by performing DSA immediately after increasing the myocardial oxygen demands by atrial pacing.
The advantages and disadvantages of DSA in relation to other semi-or non-invasive imaging modalities are discussed.
Similar content being viewed by others
References
Crummy AB, Strother CM, Sackett JF, Ergun DL, Shaw CG, Kruger RA, Mistretta CA, Turnipseed WS, Lieberman RP, Myerowitz PD, Ruzicka FF (1980) Computerized fluoroscopy: Digital subtraction for intravenous angiocardiography and arteriography. AJR 135:1131–1140
Frost MM, Fisher HD, Nudelman S, Roehrig H (1977) A digital video acquisition system for extraction of subvisual information in diagnostic medical imaging. Proc SPIE, Appl Opt Instrument Med VI, Sept 25–27, 1977, Boston, Massachusetts, 127:208–215
Meaney TF, Weinstein MA, Buonocore E, Pavilcek W, Borkowski GP, Gallagher JH, Sufka B, McIntyre W (1980) Digital subtraction angiography of the human cardiovascular system. AJR 135:1153–1160
Ovitt TW, Christenson PC, Fisher HD, Frost MM, Nudelman S, Roehrig H, Seeley G (1980) Intravenous angiography using digital video subtraction: X-ray imaging system. AJR 135:1141–1144
Sasayama S, Nonogi H, Kawai C, Eiho S, Kuwahara M (1981) Automated method for left ventricular volume measurement by cine ventriculography with minimal doses of contrast medium. Am J Cardiol 48:746–753
Mistretta CA (1974) The use and general description of the radiological transmission image for categorizing image enhancement procedures. Opt Eng 13:134
Gerber KH, Tubau JT, Witztum KF, Butterfield TK, Higgins CB, Ashburn WL, Hall DR (1981) Spatial and temporal convolutions for frequency filtering of radionuclide ventriculography (RNV) (abstr). Invest Radiol 16:371
Nelson JA, Miller FJ Jr, Kruger RA, Liu P-Y, Bateman W (1982) Digital subtraction angiography using a temporal band pass filter: Initial clinical results. Radiology 145:309
Kruger RA, Mistretta CA, Crummy AB (1977) Digital K-edge subtraction radiography. Radiology 1256:243–246
Gerber KH, Slutsky RA, Ashburn WL, Higgins CB (1982) Detection and assessment of severity of regional ischemic left ventricular dysfunction by digital fluoroscopy. Am Heart J 104:27
Slutsky RA, Carey PH, Higgins CB (1982) The effect of acute incremental volume overload on cardiac chamber size, function and the pulmonary circulation: Analysis by digital intravenous ventriculography. Am Heart J 104:254
Slutsky RA, Gerber KH, Higgins CB (1983) Digital intravenous ventriculography: Analysis and validation of wall thickness changes during ischemia and inotropic stimulation in dogs. Am J Cardiol 50:874–880
Carey PH, Slutsky RA, Ashburn WL, Higgins CB (1982) The validation of cardiac output by digital intravenous ventriculography in dogs: Correlation with thermodilution estimates. Radiology 143:623–626
Norris SL, Slutsky RA, Mancini GBJ, Gregoratos G, Ashburn WL, Peterson KL, Higgins CB (1983) Comparison of digital intravenous ventriculography with direct left ventional ventriculography for quantitation of left ventricular volumes and ejection fractions. Am J Cardiol 51:1399–1403
Low R, Nissen S, Booth D, Takeda P, DeMaria A (1982) Evaluation of left ventricular function by digital subtraction ventriculography: Comparison with cineangiography and assessment of interobserver variability (abstr). Circulation [Suppl II] 66:228
Ross AM, Johnson R, Wasserman AG, Katz RJ, Bren GB, Leiboff H, Barghese PJ (1982) Intravenous digital left ventriculography at rest and with atrial pacing as a screening procedure for coronary disease (abstr) Circulation [Suppl II] 66:228
Vas R, Diamond GA, Forrester JS, Whiting JS, Swan HJC (1982) Computer enhancement of direct and venous injected left ventricular contrast angiography. Am Heart J 102:719
Fisher J, Carter J, Cohen B, Skelly NT, Goldberg HL, Borer JS, Moses JW (1982) Intravenous digital subtraction left ventricular angiography: Comparison with standard left ventricular cineangiography (abstr) Circulation [Suppl II] 66:227
Tobis J, Nalcioglu O, Seibert JA, Roeck WW, Johnston W, Henry WL (1982) Comparison of videodensitometry and area-length methods for computing left ventricular ejection fraction from digital intravenous ventriculograms (abstr). Am J Cardiol 49:964
Shaw CG, Ergun DL, Myerowitz PD, Lysel MSV, Mistretta CA, Zarnstorff WC, Crummy AB (1982) A technique of scatter and glare correction for videodensitometric studies in digital subtraction videoangiography. Radiology 142:209–213
Mancini GBJ, Einsidler E, Norris SL, Widmann TF, Gregoratos G, Peterson KL, Higgins CB (1983) Quantitative assessment of segmental wall motion abnormalities at rest and after atrial pacing using digital intravenous ventriculography. J Am Coll Cardiol 2:70–76
Mancini GBJ, Widmann T, Norris SL, Gregoratos G, Peterson KL, Higgins CB (1983) The effects of atrial pacing on global and regional left ventricular function in coronary patients assessed by digital intravenous angiography (abstr). J Am Coll Cardiol 1:672
Kruger RA, Mistretta CA, Houck TL, Kubal W, Riederer SJ, Ergun DL, Shaw CG, Lancaster JC, Rowe GG (1979) Computerized fluoroscopic techniques for intravenous study of cardiac chamber dynamics. Invest Radiol 14:279–287
Norris SL, Widmann TF, Mancini GBJ, Slutsky RA, Gregoratos G, Peterson KL, Einsidler E, Ashburn WL, Higgins CB (1982) Quantitative assessment of segmental wall motion at rest and after atrial pacing using digital intravenous ventriculography (abstr) Circulation [Suppl II] 66:228
Botvinik E, Dunn R, Frais M, O'Connell W, Shosa D, Herfkens R, Scheimmas M (1982) The phase image: Its relationship to patterns of contraction and conduction. Circulation 65:551–560
Bacharach SL, Green MV, Bonow RD, deGraaf CN, Johnston GS (1982) A method for objective evaluation of functional images. J Nucl Med 23:285–290
Tobis JM, Nalcioglu O, Johnston WD, Seibert JA, Henry WL (1982) Exercise digital subtraction angiograms in patients with coronary artery disease (abstr) Circulation [Suppl II] 66:228
Ingels NB, Daughters GT II, Stinson EB, Alderman EL (1975) Measurement of midwall myocardial dynamics in intact man by radiography of surgically implanted markers. Circulation 52:859–867
Leighton RF, Pollack MEM, Welch TG (1975) Abnormal left ventricular wall motion at mid-ejection in patients with coronary heart disease. Circulation 52:238–244
Higgins CB, Gerber KH, Mattrey RF, Slutsky RA (1982) Evaluation of hemodynamic effects of intravenous administration of ionic and nonionic contrast materials. Implications for deriving physiologic measurement from CT and digital cardiovascular imaging. Radiology 142:681–686
Mancini GBJ, Ostrander DR, Slutsky RA, Shabetai R, Higgins CB (1983) Comparative effects of ionic contrast agents injected intravenously or directly into the left ventricle: Implications for digital angiography. AJR 140:425–430
Gerber KH, Higgins CB, Yuh YS, Koziol JA (1982) Regional myocardial hemodynamic and metabolic effects of ionic and nonionic contrast media in the normal and ischemic state. Circulation 65:1307–1314
Mancini GBJ, Bloomquist JN, Bhargava V, Stein JB, Lew W, Slutsky RA, Shabetai R, Higgins CB (1983) Hemodynamic and electrocardiographic effects in man of a new nonionic contrast agent (Iohexol): Advantages over ionic agents. Am J Cardiol 51:1218–1222
Higgins CB, Norris SL, Gerber KH, Slutsky RA, Ashburn WL Baily N (1982) Quantitation of left ventricular dimensions and function by digital video subtraction angiography. Radiology 144:461–469
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
John Mancini, G.B., Higgins, C.B., Norris, S.L. et al. Cardiac imaging with digital subtraction angiography. Cardiovasc Intervent Radiol 6, 252–262 (1983). https://doi.org/10.1007/BF02552445
Issue Date:
DOI: https://doi.org/10.1007/BF02552445