[Limits of the diagnostic capability of pulmonary digital subtraction angiography]

Digital subtraction pulmonary angiography was performed in 70 patients suspected of having pulmonary emboli. In 35 patients this diagnosis proved to be correct. The technical quality of all ECG-gated studies was scored and was found to be satisfactory in 31 patients (44%), moderate in 23 (33%) and unsatisfactory in 16 patients (23%). This was mainly due to the lack of patient cooperation. In patients with direct injection into the pulmonary artery (27%) the motion artifacts were less disturbing. We therefore suggest that even when using ECG-gated acquisitions, the injection should be performed into the pulmonary artery to overcome technical problems in the diagnosis of pulmonary embolism.