Influence of cardiac function on the quality of intravenous digital subtraction arteriograms

In a retrospective comparison between 22 pairs of matched intravenous digital subtraction angiogram (DSA) images, five angiographers made independent determinations as to which one of each pair was superior in image quality (110 image comparisons). Matched pairs were identical for anatomic region filmed, catheter position during injection, amount of contrast material injected, injection rate, and iodine concentration of the contrast material. Each pair consisted of images from one patient with a normal (less than 1 S.D. above the mean) sodium dehydrocholate circulation time and images from one patient with a prolonged (greater than 1 S.D. above the mean) circulation time. In 85 of the 110 instances (77.3%) an image judged superior in quality to its matched counterpart derived from a DSA exam in a patient with normal circulation time; images from the exam with prolonged circulation time were judged equal in quality to the ones with the normal circulation time in 14 comparisons (12.3%); in 11 comparisons (10%) the images from the DSA with the prolonged circulation time were judged superior to the ones from the DSA with the normal circulation time. These results show that with statistically significant frequency (P less than 0.001) observers judge intravenous DSA images deriving from patients with normal circulation times superior in quality to those deriving from patients with prolonged circulation times.