Right ventricular imaging with digital subtraction angiocardiography using intraventricular contrast injection

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• Conventional angiocardiography is valuable for right ventricular (RV) dimensional analysis but requires substantial contrast medium.
• Minimizing contrast and radiation exposure is crucial, especially in pediatric patients.

Purpose of the Study:

• To evaluate the efficacy of digital subtraction angiography (DSA) for accurate RV volume measurements in children with congenital heart disease.
• To assess the reduction in contrast medium, flow rate, radiation, and ventricular ectopic activity using DSA compared to conventional methods.

Main Methods:

• DSA was applied to biplane RV projections in 25 children with congenital heart disease.
• A small dose of contrast medium was directly injected into the RV.
• Volume measurements were compared with those from conventional angiocardiography.

Main Results:

• Contrast medium volume was reduced to 30% of conventional methods.
• Flow rate was reduced to 57%, and ventricular ectopic activity to 60%.
• Radiation exposure was considerably reduced.
• Excellent correlation was found for end-diastolic (r=0.996) and end-systolic volumes (r=0.990).

Conclusions:

• Digital subtraction angiography after selective RV injection provides accurate RV volume measurements in pediatric congenital heart disease.
• DSA offers significant benefits including reduced contrast, flow rate, radiation, and ventricular ectopy.