Nonselective Intra-arterial CT Angiography Versus Selective Digital Subtraction Angiography for Detecting
Wei-Chen Liao1, Hao-Yu Huang1, Yu-Hsin Chen1
1Department of Radiology, Tri-Service General Hospital, National Defense Medical University, No. 325, Sec. 2, Cheng-Kung Rd, Neihu, Taipei, 114, Taiwan.
Cardiovascular and Interventional Radiology
|July 29, 2026
Summary
Intra-arterial CT angiography (IA-CTA) is more effective than digital subtraction angiography (DSA) for identifying the small blood vessels in adhesive capsulitis. IA-CTA offers improved sensitivity and reader agreement for detecting synovial neovascularization.
Area of Science:
- Interventional Radiology
- Diagnostic Imaging
- Musculoskeletal Imaging
Background:
- Adhesive capsulitis treatment via transarterial embolization (TAE) relies on detecting periarticular neovascularization.
- This neovascularization is often subtle and difficult to visualize with conventional digital subtraction angiography (DSA).
Purpose of the Study:
- To compare the diagnostic performance of intra-arterial CT angiography (IA-CTA) against DSA for identifying synovial neovascularization in patients with adhesive capsulitis.
- To evaluate sensitivity, specificity, and inter-reader agreement between the two imaging modalities.
Main Methods:
- A prospective, single-center study enrolled 21 participants with adhesive capsulitis.
- Nonselective IA-CTA was performed, followed by selective DSA-guided embolization.
- Two radiologists independently scored six periarticular sites per shoulder for neovascularization using both IA-CTA and DSA.
Main Results:
- IA-CTA demonstrated a significantly higher area under the receiver operating characteristic curve (AUC) compared to DSA (0.901 vs. 0.769, p < 0.01).
- IA-CTA showed higher sensitivity (68.5% vs. 47.9%, p = 0.01) and better inter-reader agreement (κ = 0.75 vs. 0.65, p < 0.01).
- Specificity was comparable between IA-CTA (95.4%) and DSA (92.3%).
Conclusions:
- Nonselective IA-CTA offers superior diagnostic performance for detecting synovial neovascularization in adhesive capsulitis compared to DSA.
- IA-CTA provides higher sensitivity and improved inter-reader agreement, aiding in more precise embolization.
- This suggests IA-CTA is a valuable tool for guiding TAE in adhesive capsulitis.
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