Related Experiment Videos
Evaluation of left ventricular performance using digital subtraction angiography
Insights
Digital subtraction angiography enhances left ventricular imaging after intravenous or small-volume injections. This technique provides accurate assessments of cardiac performance and anatomy, proving highly useful in clinical practice.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Digital subtraction angiography (DSA) shows promise for cardiac applications.
- Limited studies have correlated DSA with contrast ventriculography.
- Evaluating left ventricular (LV) function and anatomy with DSA is crucial.
Purpose of the Study:
- To assess LV volume, ejection fraction, and regional wall motion using DSA.
- To compare DSA with conventional contrast ventriculography after intravenous and direct LV injections.
- To determine the diagnostic quality and correlation of DSA findings.
Main Methods:
- DSA was performed after intravenous injection of 40 ml contrast medium.
- DSA was also evaluated after small-volume (5-10 ml) direct LV injections.
- Results were compared with a film-based system using large-volume (40 ml) direct LV injections.
Main Results:
- Intravenous DSA provided diagnostic quality in 9/12 studies.
- Close correlations were found between intravenous DSA and direct injection for LV ejection fraction (r=0.89) and volume (r=0.91).
- Small-volume direct LV injection with DSA showed strong correlations for LV ejection fraction (r=0.91) and volume (r=0.96), with 87% regional wall motion correspondence.
Conclusions:
- DSA significantly improves left ventricular visibility via intravenous or small-volume direct injection.
- DSA provides excellent estimates of LV volume and is valuable for studying cardiac performance and anatomy.
- DSA offers a promising, less invasive alternative for cardiac imaging.
Abstract:
Cardiac applications for digital subtraction angiography appear promising, but few correlative studies with contrast ventriculography have been done. Left ventricular volume, ejection fraction, and regional wall motion by digital subtraction angiography were evaluated after intravenous injection of 40 ml of iodinated contrast medium and after left ventricular injection of 5 to 10 ml of contrast medium. A film-based system of the authors' own design was used. Results were compared with those after direct left ventricular injection of 40 ml of contrast medium. The ventriculograms after intravenous injection were of diagnostic quality in 9 of 12 studies, and there were close correlations between intravenous and direct-injection studies for left ventricular ejection fraction (r = 0.89, n = 9, and p = 0.001) and for left ventricular volume (r = 0.91, n = 18, and p less than 0.001). Regional wall motion scores showed close correspondence in 83% of sectors. After small-volume left ventricular injections, the ventricular image was enhanced considerably by digital subtraction. Correlations between small- and large-volume ventriculograms were close for left ventricular ejection fraction (r = 0.91, n = 8, and p = 0.002) and for left ventricular volume (r = 0.96, n = 16, and p less than 0.001). There was close correspondence of wall motion scores in 87% of sectors. Thus, digital subtraction angiography improves the visibility of the left ventricle after either intravenous or small-volume direct left ventricular injection. Digital images produce excellent estimates of left ventricular volume and should have considerable usefulness for the study of cardiac performance and anatomy.