Radiology, Vol 207, 695-703, Copyright © 1998 by Radiological Society of North America
Lower extremity: nonstepping digital angiography with photostimulable imaging plates versus conventional angiography
E Therasse, G Soulez, P Roy, A Gauvin, VL Oliva, R Carrier and P Robillard
Department of Radiology, University of Montreal Medical Center, Hotel- Dieu Pavilion, Montreal, Quebec, Canada.
PURPOSE: To compare nonstepping digital subtraction angiography (DSA) (ie,
storage phosphor radiography adapted to a stationary imaging plate changer)
with conventional screen-film angiography in the evaluation of the lower
extremities. MATERIALS AND METHODS: Fifty-one patients with peripheral
vascular disease underwent both nonstepping DSA and screen- film
angiography. The angiographic and radiologic techniques of both systems
were kept identical for each patient. Three radiologists independently
rated the overall quality of each angiogram. In their evaluations for each
of 12 arterial segments on all 102 angiograms, they also rated the degree
of opacification, the diameter reduction of the most severe stenosis, and
their level of confidence. RESULTS: Mean overall quality scores and levels
of confidence were better for nonstepping DSA than for screen-film
angiography (P < .001). Full opacification was reported in 95.6% and
89.2% of all 1,836 segments with nonstepping DSA and screen-film
angiography, respectively (P < .0001). The difference between the mean
stenosis grades obtained with screen-film angiography and nonstepping DSA
was not statistically significant. Intertechnique agreements were good
(kappa = 0.77, 0.81, and 0.81), whereas interobserver agreements were
influenced by the observer's experience with the imaging techniques.
CONCLUSION: Nonstepping DSA images of the lower extremity were of better
diagnostic quality than were screen-film angiograms. The development of
dedicated nonstepping DSA equipment is warranted.
