Abstract
Objective:Three-dimensional (3D) digital subtraction angiography (DSA) is becoming a common technique for the assessment of the cerebral arteries. Nevertheless, the injection parameters for each artery are not standardized among institutions. The objective of this study was to analyze the relationship between injection rate and contrast enhancement on 3D DSA of the common carotid artery.Materials and methods:Twenty-four patients who underwent 3D DSA of the common carotid artery from June 2013 to March 2015 were included in this retrospective study. Contrast enhancement of each patient was analyzed for four cerebral arteries segments (A1, A2, M1 and M2) by measuring the average pixel value on the source rotational two-dimensional DSA images. Linear regression analysis was used to investigate the correlation between injection rate and contrast enhancement.Results:All four regression lines showed that a higher injection rate led to higher contrast enhancement. There was a significant relationship for the A1, A2 and M1 segments (P = 0.008, 0.03 and < 0.001) but not for the M2 segment (P = 0.13). The goodness-of-fit of the regression lines was high for the M1 segment (R2 = 0.63). However, as the size of the vascular lumen became narrower, the value for the A1 (R2 = 0.28) and A2 (R2 = 0.19) segments became lower.Conclusion:In 3D DSA of the common carotid artery, contrast enhancement of a relatively wide lumen could be optimized by adjusting the injection rate. However, it is difficult to optimize the contrast enhancement of a relatively narrow lumen only by adjusting the injection rate.
Highlights
The 3D digital subtraction angiography (DSA) examination was started with the contrast medium filled to the catheter tip, and injection was continued until scanning was completed
The relationship between the injection rate and contrast enhancement for each segment is shown in Figure 2, with the straight line fitted by linear regression
All four regression lines showed that a higher injection rate led to higher contrast enhancement
Summary
Three-dimensional (3D) digital subtraction angiography (DSA), which combines two-dimensional (2D) DSA and gantry rotation, is becoming a common technique for the assessment and the treatment of the cerebral arteries [1,2,3,4,5,6,7,8,9,10].In most studies of 3D DSA, the injection rate and the volume of contrast medium have been determined based on the arteries involved and the position of the catheter tip [1, 2, 4,5,6,7,8,9]. There has been a report on the relationship between the injection rate and image quality on 3D DSA when the contrast medium was injected from the internal carotid artery [12]. In that study, only relatively thick blood vessels (internal carotid artery, proximal A1 segment, and proximal M1 segment) were evaluated, and the distal relatively thin blood vessels were only assessed by eye. It is unknown whether there is a similar relationship when the contrast medium is injected from the common carotid artery
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