Radiology, Vol 152, 19-22, Copyright © 1984 by Radiological Society of North America
EKG-gated digital subtraction angiography in the detection of pulmonary emboli
M Hirji, G Gamsu, WR Webb, AC Brito, K Kuriyama, RG Stern and L Cox
Detection of pulmonary emboli was investigated using
electrocardiographically gated (EKG-gated) intravenous digital subtraction
angiography (DSA) in 6 anesthetized and paralyzed dogs. Six autologous
blood clots were introduced into the internal jugular vein of each dog and
both conventional pulmonary angiography and EKG-gated DSA performed in
frontal and oblique projections. When two observers scored any definite or
equivocal embolus as positive, sensitivity was 82.1% for one and 92.9% for
the other; the respective positive predictive values (PPV) were 88.5% and
65%. When only definite emboli were considered positive, sensitivity was
75% for one observer and 71.4% for the other; PPV was 100% for both. The
authors conclude that DSA can demonstrate individual emboli with good
sensitivity and excellent precision. If several emboli are present,
EKG-gated DSA should prove highly accurate; however, care must be taken
because overinterpretation is more likely with DSA than with conventional
pulmonary angiography.
