TY - JOUR
T1 - Digital subtraction versus film-screen angiography for detecting acute pulmonary emboli
T2 - Evaluation in a porcine model
AU - Schlueter, Francis J.
AU - Zuckerman, Darryl A.
AU - Horesh, Larry
AU - Gutierrez, Fernando R.
AU - Hicks, Marshall E.
AU - Brink, James A.
N1 - Funding Information:
Abbreviations: CI = confidence interval, DSA = digital subtraction angiography, FSA = film-screen angiography, PE = pulmonary embolism, PV+ = predictive value of a positive case From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110. Received February 27, 1997; revision requested April 1; revision received and accepted July 8. This study was funded in part by grants from Mallinckrodt Medical, Inc., St. Louis, Missouri, and Siemens Medical Systems, Iselin, New Jersey. From the 1996 SCVIR annual meeting. Address correspondence to F.J.S., Good Samaritan Hospital, Department of Radiology, 375 Dixmyth Ave, Cincinnati, OH 45220.
PY - 1997
Y1 - 1997
N2 - PURPOSE: To compare the diagnostic performance of digital subtraction angiography (DSA) to that of film-screen angiography (FSA) for detecting acute pulmonary embolism (PE) in a porcine model. MATERIALS AND METHODS: DSA and FSA were performed in 13 pigs before and after central venous administration of autologous emboli. Results were compared to findings at necropsy with use of ex vivo pulmonary angiography to guide pathologic sectioning. The sensitivity and predictive value of a positive case for detecting each embolus were computed for each pulmonary artery branch order and compared with use of 95% confidence intervals. Interobserver variability among three readers for individual PE detection was calculated. RESULTS: Pathologic examination of the lungs revealed 100 total PEs (location by vessel order: 1st = 1, 2nd = 0, 3rd = 15, 4th = 32, > 5th = 52). On average, FSA review identified 72 (72%) emboli and DSA review, 65 (65%). There was no significant difference in sensitivity or predictive value of a positive case between DSA and FSA for detecting emboli (P > .05). There was similar agreement among readers for individual PE detection with DSA (mean, 84%) and FSA (mean, 80%). CONCLUSION: The diagnostic performance of DSA is equivalent to that of FSA for detecting emboli in porcine PA branches. Interobserver agreement for individual PE detection is similar for both imaging techniques.
AB - PURPOSE: To compare the diagnostic performance of digital subtraction angiography (DSA) to that of film-screen angiography (FSA) for detecting acute pulmonary embolism (PE) in a porcine model. MATERIALS AND METHODS: DSA and FSA were performed in 13 pigs before and after central venous administration of autologous emboli. Results were compared to findings at necropsy with use of ex vivo pulmonary angiography to guide pathologic sectioning. The sensitivity and predictive value of a positive case for detecting each embolus were computed for each pulmonary artery branch order and compared with use of 95% confidence intervals. Interobserver variability among three readers for individual PE detection was calculated. RESULTS: Pathologic examination of the lungs revealed 100 total PEs (location by vessel order: 1st = 1, 2nd = 0, 3rd = 15, 4th = 32, > 5th = 52). On average, FSA review identified 72 (72%) emboli and DSA review, 65 (65%). There was no significant difference in sensitivity or predictive value of a positive case between DSA and FSA for detecting emboli (P > .05). There was similar agreement among readers for individual PE detection with DSA (mean, 84%) and FSA (mean, 80%). CONCLUSION: The diagnostic performance of DSA is equivalent to that of FSA for detecting emboli in porcine PA branches. Interobserver agreement for individual PE detection is similar for both imaging techniques.
KW - Digital subtraction angiography, comparative studies
KW - Embolism, pulmonary
KW - Pulmonary angiography
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U2 - 10.1016/S1051-0443(97)70704-8
DO - 10.1016/S1051-0443(97)70704-8
M3 - Article
C2 - 9399472
AN - SCOPUS:0030671180
SN - 1051-0443
VL - 8
SP - 1015
EP - 1024
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 6
ER -