Image Quality and Vessel Rendering Ability of Dynamic Range Compression-Processed Images of Peripheral Vessels in Digital Subtraction Angiography.

Abstract

Background: In emergency interventional radiology (IR), patient motion and poor breath-holding often result in misregistration during digital subtraction angiography (DSA). As a countermeasure, digital angiography (DA) without subtraction processing is used for observation; however, evaluation is limited to areas overlapping with low X-ray transmissivity structures, such as bone. Dynamic trace (DT) is capable of real-time background compression processing of peripheral blood vessels in DA images and ensures visibility of blood vessels in such areas, without being affected by body motion. We evaluated the image quality and visualization of peripheral vascularity of DA and DT images obtained from DSA of the trunk and examined the usefulness of DT.

Methods: Data from 13 patients who underwent emergency IR involving trunk DSA between October 2022 and June 2023 were analyzed. DA and DT images were created from these angiographic images, and two independent IR specialists used a 4-point scale to visually evaluate the contrast, sharpness, and peripheral vascular visibility of the proximal and distal portions of 42 arteries. The image quality scores for DA and DT images were compared using the Wilcoxon signed-rank test, and inter-rater agreement was evaluated using weighting coefficients.

Results: As compared with the DA images, the DT images were significantly better at all endpoints (P < 0.001). Inter-rater agreement was moderate for all assessment items.

Conclusions: DT images are not affected by body motion and display better image quality and visualization of peripheral vascularity than DA images, making them useful for emergency IR of the trunk.