Accuracy Of Digital Subtraction Angiography Research Articles

Diagnostic value of multi-slice spiral computed tomography angiography for intracranial aneurysm.

To investigate the clinical value of multi-slice spiral computed tomography angiography (MSCTA) in the diagnosis of intracranial aneurysms (ICA). The imaging data of 68 patients suspected of having ICA who were examined in the Department of Radiology of the First Affiliated Hospital of Nanjing Medical University from March 2018 to March 2021 were retrospectively analyzed. MSCTA and digital subtraction angiography (DSA) were performed on each patient, and the MSCTA imaging analysis was compared with DSA. The accuracy of DSA in the diagnosis of ICA was 98.53% (67/68), while the accuracy of MSCTA in the diagnosis of ICA was 97.06% (66/68), with no significant difference in diagnostic accuracy (P > 0.05). There were no significant differences in the diameter of the aneurysm, the width of the aneurysm neck, or the location of the aneurysm in the comparison of the ICA image between DSA and MSCTA (P > 0.05). MSCTA offers high accuracy and has favorable clinical value in the diagnosis of ICA. It is worth popularizing as the recommended examination method in clinical practice.

Construction of Diagnosis Model of Moyamoya Disease Based on Convolution Neural Network Algorithm.

Objective The convolutional neural network (CNN) was used to improve the accuracy of digital subtraction angiography (DSA) in diagnosing moyamoya disease (MMD), providing a new method for clinical diagnosis of MMD. Methods A total of 40 diagnosed with MMD by DSA in the neurosurgery department of our hospital were included. At the same time, 40 age-matched and sex-matched patients were selected as the control group. The 80 included patients were divided into training set (n = 56) and validation set (n = 24). The DSA image was preprocessed, and the CNN was used to extract features from the preprocessed image. The precision and accuracy of the preprocessed image results were evaluated. Results There was no significant difference in baseline data between the training set and validation set (P > 0.05). The precision and accuracy of the images before processing were 79.68% and 81.45%, respectively. After image processing, the precision and accuracy of the model are 96.38% and 97.59%, respectively. The area under the curve of the CNN algorithm model was 0.813 (95% CI: 0.718-0.826). Conclusion This diagnostic method based on CNN performs well in MMD detection.

Deep Learning-Based Magnetic Resonance Imaging in Diagnosis and Treatment of Intracranial Aneurysm.

This study was focused on the positioning of the intracranial aneurysm in the magnetic resonance imaging (MRI) images using the deep learning-based U-Net model, to realize the computer-aided diagnosis of the intracranial aneurysm. First, a network was established based on the three-dimensional (3D) U-Net model, and the collected image data were input into the network to realize the automatic location and segmentation of the aneurysm. The 3D convolutional neural network (CNN) network can extract the aneurysm blood vessels to locate and identify the areas of possible aneurysms. Next, 40 patients highly suspected of intracranial aneurysm were selected as research subjects, and they were subjected to magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) examinations. The results showed that based on the U-Net algorithm model, 40 patients' hemangiomas were completely contained in the labeling bounding box, one patient's hemangioma was at the edge of the labeling bounding box, and 4 patients' hemangiomas were outside the labeling box. The final accuracy coefficient was 88.9%, and it was in good agreement with the doctor's manual labelling results. Under the 3D CNN network test, the sensitivity, specificity, and accuracy of DSA for intracranial aneurysm were 91.46%, 86.01%, and 90.2%, respectively; the sensitivity, specificity, and accuracy of MRA for intracranial aneurysm were 95.87%, 100%, and 97.19%, respectively. In conclusion, the 3D CNN can successfully realize the positioning of intracranial aneurysm in MRA images, providing a certain theoretical basis for subsequent imaging diagnosis of aneurysm.

Learning spatiotemporal features of DSA using 3D CNN and BiConvGRU for ischemic moyamoya disease detection

Background Moyamoya disease (MMD) is a serious intracranial cerebrovascular disease. Cerebral hemorrhage caused by MMD will bring life risk to patients. Therefore, MMD detection is of great significance in the prevention of cerebral hemorrhage. In order to improve the accuracy of digital subtraction angiography (DSA) in the diagnosis of ischemic MMD, in this paper, a deep network architecture combined with 3D convolutional neural network (3D CNN) and bidirectional convolutional gated recurrent unit (BiConvGRU) is proposed to learn the spatiotemporal features for ischemic MMD detection. Methods Firstly, 2D convolutional neural network (2D CNN) is utilized to extract spatial features for each frame of DSA. Secondly, the long-term spatiotemporal features of DSA sequence are extracted by BiConvGRU. Thirdly, the short-term spatiotemporal features of DSA are further extracted by 3D convolutional neural network (3D CNN). In addition, different features are extracted when gray images and optical flow images pass through the network, and multiple features are extracted by features fusion. Finally, the fused features are utilized to classify. Results The proposed method was quantitatively evaluated on a data sets of 630 cases. The experimental results showed a detection accuracy of 0.9788, sensitivity and specificity were 0.9780 and 0.9796, respectively, and area under curve (AUC) was 0.9856. Compared with other methods, we can get the highest accuracy and AUC. Conclusions The experimental results show that the proposed method is stable and reliable for ischemic MMD detection, which provides an option for doctors to accurately diagnose ischemic MMD.

320-Detector row CT angiography for detection and evaluation of intracranial aneurysms: Comparison with conventional digital subtraction angiography

To compare the diagnostic performance of 320-detector row computed tomographic angiography (CTA) with digital subtraction angiography (DSA) for the detection and characterization of intracranial aneurysms. Fifty-two consecutive patients with non-traumatic subarachnoid haemorrhage (SAH) and suspected intracranial aneurysms were evaluated from January 2009 to October 2011. All underwent both 320-detector row volume CTA examination and DSA. CTA volume data were transmitted to a VITREA workstation and two physicians with experience in diagnostic imaging of the nervous system independently carried out image post-processing and assessed the results. The three-dimensional (3D) CTA and DSA images were assessed using intraoperative findings as the reference standard. In 52 patients, 54 aneurysms were detected; 48 patients underwent surgery for 50 aneurysms. The overall sensitivity, specificity, and accuracy of 3D CTA were 96.3, 100, and 94.6%, respectively. Meanwhile, the overall sensitivity, specificity, and accuracy of DSA were 98.1, 98.1, and 95.1%, respectively. For aneurysms less than 3 mm, the sensitivity, specificity, and accuracy of 3D CTA were 81.8, 100, and 93.3%, respectively. The sensitivity, specificity, and accuracy of DSA for small aneurysms were 90.9, 100, and 96.2%, respectively. 3D CTA was superior to DSA in demonstrating aneurysmal calcification, parent artery, and surrounding vascular anatomy. 3D CTA is a highly sensitive, specific, and non-invasive imaging method for diagnosis and evaluation of intracranial aneurysms. It also allows for precise depiction of aneurysm morphology. Therefore, 320-detector row CTA may be used as an alternative to DSA as a first-line imaging technique in patients with SAH.

Idiopathic Thrombus in the Common Carotid Artery on Digital Subtraction Angiography

In the present study, we discuss the accuracy of digital subtraction angiography (DSA) in diagnosis of thrombus in the common carotid artery and its role in the medical management of this disorder. Between 2006 and 2011, four patients (age group ranging from 26 to 48 years) presented to our institution with symptoms of stroke. DSA in all these patients showed cigar-shaped filling defect in the common carotid artery. All the patients were managed successfully with anticoagulation treatment. Follow-up Duplex scan was done in all the patients. DSA is the gold standard to diagnose free floating thrombus in the common carotid artery. Medical management can be effective in these patients but a multidisciplinary team approach is needed for appropriate management.

Accuracy of Digital Subtraction Angiography, Computed Tomography Angiography, and Magnetic Resonance Angiography in Grading of Carotid Artery Stenosis in Comparison With Actual Measurement in an In Vitro Model

The aim of this study was to investigate the accuracy of digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance angiography (MRA) in grading of carotid stenosis compared with actual measurement in an in vitro model. Various grades of stenosis were created by adhering different amounts of silicone rubber sealant onto the inner wall of clear, radiolucent tubes. After DSA, CTA, and MRA, the tubes were transected with 1-mm interval through the plaques. The cross-sectional areas were digitally photographed, and the percentage of area reduction of every single slide was measured with ImageJ planimetric software. The maximum actual area reduction (AAR) stenosis of each tube was recorded. The differences among DSA, CTA, MRA, and AAR were compared statistically using paired Student t test. Overall, CTA and MRA significantly underestimated the degrees of stenosis compared with AAR (P = 0.001 and P = 0.0009, respectively), and no significant difference was found between DSA and AAR (P = 0.40). In the subgroup with stenosis of <70%, there was no significant difference between DSA, CTA, and MRA versus AAR (P = 0.18, P = 0.16, and P = 0.08, respectively). In the subgroup with severe stenosis of >70%, CTA and MRA significantly underestimated the stenosis versus AAR (P = 0.004, and P = 0.007 respectively), and DSA significantly overestimated the stenosis (P = 0.0007). This in vitro model study demonstrated that CTA and MRA underestimate the lesions in severe stenosis of >70%. DSA tends to overestimate the disease. The accuracy of DSA is affected by plaque morphology, such as mountain-shaped lesions.

A prospective clinical study on early recurrence of hepatocellular carcinoma after hepatectomy

To determine more precisely time interval from resection to recurrence of hepatocellular carcinoma (HCC) and to identify the risk factors associated with postoperative recurrence. From January 2004 to December 2007, 178 patients who underwent resection of HCC were followed prospectively for at least 12 months. Recurrence was identified by the digital subtraction angiography (DSA). Demographic, tumor, and disease characteristics were compared between patients with recurrence within 6 months and between 7 and 12 months, and those without recurrence to evaluate for their prognostic significance. Patients with intrahepatic recurrence were treated with trans-arterial chemoembolization (TACE) and re-assessed by CT scans, contrast-enhanced ultrasound, or MRI. Recurrence developed in 52 patients between 1 and 6 months, 11 patients between 7 and 12 months, and 115 patients remained disease free for at least 1 year. The recurrence rates of 6 months and 1 year were 29.2% and 35.4%, respectively. No statistically significant difference between was observed. Fourteen (22.2%) patients with recurrence and 11 (9.6%) patients without recurrence had previously presented as multifocal HCC, and the difference is of statistical significance (P = 0.025). The diagnostic accuracy of DSA as validated by other diagnostic methods was 81.8%. Recurrences are more likely to develop within the first 6 months after resection for HCC. Multifocal HCC is an important risk factor associated with early recurrence of advanced HCC after hepatectomy. DSA may serve as an important surveillance for early detection of intrahepatic recurrence after surgery.

Comparing the Accuracy of Digital Subtraction Angiography, CT Angiography and MR Angiography at Estimating the Volume of Cerebral Aneurysms

While there are many studies that compare imaging modalities in the detection of cerebralaneurysms there are no existing studies that compare two dimensional digital subtraction angiography (DSA), CT angiography (CTA) and MR angiography (MRA) in calculating the volume of cerebral aneurysms. This study will compare these imaging modalities on seven in vitro models of known volume. Seven silicone models of cerebral aneurysms were chosen representing slight variations in geometric shape and size. The volume of each model was measured by weighing the amount of water required to fill the aneurysm to the parentartery. Contrast enhanced images of the modelswere taken with DSA, CTA and MRA. The images were interpreted by four independent readers and the volumes were calculated. The measured volumes from the water weight analysis were compared to the volumes calculated from the interpreter's measurements. The accuracy of DSA, CTA and MRA were compared using the percent of absolute and true variance from the measured volume. The average percent absolute variance for DSA was 14.3%, CTA was 16.8% and MRA was 18.6%. While these differences were minimal, comparing the percent of true variance demonstrated an average variance of -1.9% for DSA, 16.1% for CTA and -15.9% for MRA. Calculating the volume of cerebral aneurysms, while increasingly important, is difficult and error prone. It is important to understand the limitations and inherent errors before relyingon calculated volumes in clinical decision making. Regardless of imaging modality, one should consider error rates of 14-19% for calculatingvolume while keeping in mind the tendencyfor CTA to overestimate volume, MRA to underestimate volume and DSA to both under and overestimate equally.

Accuracy of angiography and Doppler ultrasonography in the detection of carotid stenosis: a histopathological study of 123 cases

A prospective study was performed comparing the accuracy of digital subtraction angiography (DSA) and Doppler ultrasonography (DUS) stenosis findings with measurements on histological specimens. DSA and DUS were used to evaluate carotid stenosis and were compared with measurements on histological specimens. Intact carotid plaques from 123 cases were removed in one piece during surgery. The specimens were histologically processed and examined in transverse sections. The smallest inner and correlating outer diameters were measured and the extent of stenosis was calculated. Carotid artery stenoses were compared and statistics done. Specimens in symptomatic cases were divided into 3 groups: stenosis 30-49% (Group 1), stenosis 50-69% (Group 2) and stenosis 70-99% (Group 3). Specimens in asymptomatic cases were divided into two groups: stenosis<or=59% (Group A) and stenosis>or=60% (Group B). Wilcoxon paired tests revealed significant differences between DSA, DUS and measurements on histological specimens. In severe stenoses only, no significant difference was observed between stenosis measurement according to the European Carotid Surgery Trial (ECST) angiography methodology and measurements on histological specimens. The most pronounced differences were found between angiography methodology of the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and measurements on histological specimens. When investigating how often preoperative measurement classified stenosis into the same Group of stenoses as postoperative measurement, DUS was the most accurate diagnostic tool. This study confirmed our previous results, i.e., angiography underestimates the degree of carotid artery stenosis. DUS seems to be more accurate in classifying stenoses into different groups to the extent of narrowing of the carotid arteries. These results make the position of angiography in diagnostic algorithm of carotid stenoses investigations even more questionable.

Preoperative evaluation of living kidney donors using multirow detector computed tomography: comparison with digital subtraction angiography and intraoperative findings

To assess the accuracy of multirow detector computed tomography (MDCT) for the evaluation of renal anatomy for preoperative donor assessment in living related kidney transplantation. MDCT-scans (4- and 16-slice-CT) of 51 consecutive living kidney donors (age, 51.6 +/- 9.7 years; range, 28-68 years) were analysed by three blinded observers and compared with digital subtraction angiography (DSA) and surgery. Contrast-enhanced MDCT was performed with 1 mm slice thickness reconstruction interval during arterial and venous phases. Supernumerary renal arteries, veins, early branching of vessels and abnormalities of the ureters were documented. The overall accuracy of computed tomography angiography (CTA) for detection and classification of surgically relevant arterial variants was 97% (99/102). The interpretation of 16-channel MDCT images was correct in all cases (accuracy, 100%), while the four-channel CTA had three incorrect results regarding the differentiation of early branching vessels from double renal arteries (accuracy, 93%). The overall accuracy of DSA was 91%. Renal vein abnormalities were correctly diagnosed with MDCT in 100% compared with 89% correct findings with DSA. There were three kidneys with incomplete ureter duplication, detected both with MDCT and DSA. MDCT demonstrated superior accuracy compared with non-selective DSA for the preoperative assessment of renal anatomy in living kidney donors; and for the distinction of supernumerary arteries versus early branching patterns, 16-channel CTA data were better than those of the four-channel system.

Preoperative Diagnosis of Carotid Stenosis by Noninvasive Testing

Catheter-based angiography commonly is used to determine whether patients with TIAs or minor strokes have symptomatic 50%-99% stenosis of the internal carotid artery (ICA) and thus could clearly benefit from endarterectomy. However, because catheter-based angiography can cause stroke and death, these researchers prospectively compared the accuracy of digital subtraction angiography (DSA) with that of two noninvasive techniques in 350 patients with suspected symptomatic ICA disease. Carotid ultrasound (CUS) was used in 313 cases, magnetic resonance angiography …

Interobserver variability in the interpretation of renal digital subtraction angiography.

Our purpose was to analyze interobserver variability in the interpretation of renal digital subtraction angiography and to describe the main factors associated with observer discrepancies. Forty-nine cases of unilateral atheromatous renal artery stenosis of more than 60% were quantified first by local investigators in a multicenter study and then by five other radiologists. Differences between radiologists for the minimum diameter (Dmin), the reference diameter (Dref), and the percentage of stenosis of the renal arteries were analyzed. Interpretations by the local investigators were then compared with the gold standard, defined as the mean for the five radiologists. The average SD for estimation of all renal artery stenoses by all radiologists was 7% for stenosis percentage, 0.5 mm for Dmin, and 0.7 mm for Dref. Main discrepancies occurred more frequently in cases of weakly opacified renal artery stenosis and poststenotic dilatation. The observations of local investigators disagreed by more than two SDs (14%) with the gold standard for 11 of 49 cases (22%). The accuracy of digital subtraction angiography in renal artery interpretations is poor because of variations in evaluating both Dmin and Dref. Precise and reproducible methods for quantification of renal artery stenosis are required.

Accuracy of DSA in the Evaluation of Patency of Infrapopliteal Vessels

To evaluate the accuracy of intraarterial digital subtraction angiography (DSA) in the demonstration of patent infrapopliteal vessels. One-hundred sixty-five arteriograms were obtained in 153 consecutive patients prospectively enrolled to evaluate lower extremity ischemia. In 86 cases a follow-up angiogram of the infrapopliteal vessels was obtained during surgery or after endovascular intervention (n = 57). Twenty-nine arteriograms were followed by surgical exploration of the infrapopliteal vessels. Standard angiographic technique was performed with intraarterial DSA of the most symptomatic foot. Visualization of distal vessels was compared with intraoperative or postintervention imaging or with the results of surgical exploration. Of the 57 procedures after which either intraoperative or post-endovascular intervention angiography was performed, DSA results were equivalent in 47 (82%) and worse in five (9%). When individual vessels were evaluated, the sensitivity of DSA in the identification of patent named vessels was 95%, and the specificity was 92%. Among 29 cases with a surgical standard of reference, 28 patients underwent bypass to a vessel correctly identified as patent at DSA; one patient was incorrectly identified as having no patent named vessels. Intraarterial DSA is accurate and reliable in the assessment of patency in infrapopliteal vessels before surgery or endovascular intervention in patients with infrainguinal atherosclerotic disease.

Determination of left ventricular systolic wall thickness by digital subtraction angiography

The accuracy of digital subtraction angiography (DSA) for determination of left ventricular (LV) systolic wall thickness and muscle mass was evaluated in 20 patients (mean age 50 +/- 11 years). Conventional LV angiograms were digitized and subtracted using a combined subtraction mode ('mask mode' and 'time interval difference' subtraction). Wall thickness and muscle mass were determined at end-diastole, after the first- and second-third of systole and at end-systole. M-mode echocardiography (Echo), which was obtained from beam selection of the two-dimensional echocardiogram and conventional angiography (LVA), served as reference techniques. Angiographic LV wall thickness and muscle mass were determined according to the technique of Rackley in both, right (RAO) and left (LAO) anterior oblique projections, whereas echocardiographic wall thickness was measured just below the mitral valve orthogonal to the posterior wall (= LAO equivalent). Percent wall thickening was calculated in all patients. LV end-diastolic wall thickness and muscle mass correlated well between DSA and LVA (LV end-diastolic wall thickness in LAO projection r = 0.72, biplane LV end-diastolic muscle mass r = 0.83), LV end-systolic wall thickness (1.44 vs 1.33 cm, P less than 0.05) and percent wall thickening (52 vs 42%, P less than 0.05) compared favourably between echocardiography and DSA but was significantly larger when echocardiographically measured than with DSA (LAO projection). DSA and echocardiography showed a good correlation in regard to LV end-diastolic and end-systolic wall thickness (correlation coefficient r = 0.89, standard error of estimate SEE = 0.15 cm or 13% of the mean value).(ABSTRACT TRUNCATED AT 250 WORDS)

The accuracy of digital subtraction angiography for the quantification of atherosclerosis.

Digital subtraction angiography (DSA) allows the degree of arterial patency or stenosis to be rapidly quantified. We have assessed the accuracy with which a single-plane DSA system is able to quantify area patency by densitometric and geometric methods. Arterial phantoms were designed to test for systematic error; intra-arterial DSA images of critical lesions of the carotid bifurcation and the lower abdominal and peripheral vessels were used to determine intra- and interobserver reproducibility. The densitometric method, which was more accurate than the geometric method, had a mean systematic error of up to 4% and a mean intra-observer variability of about 15% (coefficient of variation). We have identified the principal sources of inaccuracy and ways in which it may be reduced.

Digital subtraction angiography with intravenous injection: assessment of 1,000 carotid bifurcations.

Digital subtraction angiography (DSA) with intravenous contrast injection was performed on 500 consecutive adult patients and evaluated for image quality of the carotid artery bifurcations. Diagnostic quality examinations were obtained in 974 common, 925 internal, and 904 external carotid artery segments. Sixty-two patients had standard carotid arteriography around the same time as DSA. Agreement of standard arteriograms with diagnostic quality DSA examinations was noted in 97 of 98 common, 94 of 95 internal, and 79 of 91 external carotid artery segments. All cases of complete carotid occlusion (14 of 14) were correctly interpreted by DSA. To identify a population with clinically significant stenosis, a 60% or greater reduction in diameter of the internal carotid was defined as a positive examination. Applying this criterion, the sensitivity, specificity, and accuracy of DSA as compared with standard arteriography was about 94%.