Pediatric digital subtraction angiography

Experience with intravenous digital subtraction angiography (DSA) in infants and children is limited, although its relative ease of performance, low complication rate, and diagnostic accuracy indicate great potential. We performed 87 DSA examinations (74 patients) and obtained sufficient detail to facilitate diagnosis in most cases. The major problems of patient movement and overlapping vessels can be minimized by judicious use of sedation and strict attention to technique. Exposure of patients to radiation has not been a limiting factor since our system uses low exposure factors (2-38 mR [.51-9.76 mu C/kg]/frame). Our results demonstrate that DSA has wide applicability to many organ systems and is especially useful in intracranial disease and for preoperative evaluation of neoplasms. More specific indications for its use in children must await further correlative studies.