Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany.
J Vasc Interv Radiol. 2022 Feb;33(2):104-112. doi: 10.1016/j.jvir.2021.09.024. Epub 2021 Oct 13.
To evaluate the potential benefits of digital variance angiography (DVA) in selective lower limb angiography and to compare the performance of 2 DVA algorithms (conventional DVA1 and the recently developed DVA2) to that of digital subtraction angiography (DSA).
From November 2019 to May 2020, 112 iodinated contrast media (ICM) and 40 carbon dioxide (CO) angiograms were collected from 15 and 13 peripheral artery disease patients, respectively. The DVA files were retrospectively generated from the same unsubtracted source file as DSA. The objectively calculated contrast-to-noise ratio (CNR) and the subjective visual image quality of DSA, DVA1, and DVA2 images were statistically compared using the Wilcoxon signed-rank test. The images were evaluated by 6 radiologists (R.P.T., S.V., A.M.K., S.S.A., O.E., and J.S.) from 2 centers using a 5-grade Likert scale.
Both DVA algorithms produced similar increase (at least 2-fold) in CNR values (P < .001) and significantly higher image quality scores than DSA, independent of the contrast agent used. The overall scores with ICM were 3.61 ± 0.05 for DSA, 4.30 ± 0.04 for DVA1, and 4.33 ± 0.04 for DVA2 (each P < .001 vs DSA). The scores for CO were 3.10 ± 0.14 for DSA, 3.63 ± 0.13 for DVA1 (P < .001 vs DSA), and 3.38 ± 0.13 for DVA2 (P < .05 vs DSA).
DVA provides higher CNR and significantly better image quality in selective lower limb interventions irrespective of the contrast agent used. Between DVA algorithms, DVA1 is preferred because of its identical or better image quality than DVA2. DVA can potentially help the interventional decision process and its quality reserve might allow dose management (radiation/ICM reduction) in the future.
评估数字方差血管造影术（DVA）在选择性下肢血管造影中的潜在优势，并比较两种 DVA 算法（传统 DVA1 和新开发的 DVA2）与数字减影血管造影术（DSA）的性能。
2019 年 11 月至 2020 年 5 月，从 15 例外周动脉疾病患者的 112 份碘造影剂（ICM）和 13 例患者的 40 份二氧化碳（CO）血管造影中收集 DVA 文件。从与 DSA 相同的未减影源文件中回顾性生成 DVA 文件。使用 Wilcoxon 符号秩检验对 DSA、DVA1 和 DVA2 图像的客观计算对比度噪声比（CNR）和主观视觉图像质量进行统计学比较。6 名放射科医生（R.P.T.、S.V.、A.M.K.、S.S.A.、O.E.和 J.S.）分别来自 2 个中心，使用 5 级 Likert 量表对图像进行评估。
两种 DVA 算法均产生了相似的 CNR 值（至少增加了 2 倍）（P<0.001），且图像质量评分显著高于 DSA，与所用造影剂无关。使用 ICM 的总体评分分别为 DSA 3.61±0.05、DVA1 4.30±0.04 和 DVA2 4.33±0.04（均 P<0.001 与 DSA）。CO 的评分分别为 DSA 3.10±0.14、DVA1 3.63±0.13（P<0.001 与 DSA）和 DVA2 3.38±0.13（P<0.05 与 DSA）。
DVA 可提供更高的 CNR，并在选择性下肢介入治疗中显著改善图像质量，而与所用造影剂无关。在 DVA 算法之间，DVA1 因其与 DVA2 具有相同或更好的图像质量而更受青睐。DVA 有可能有助于介入决策过程，其质量储备可能允许未来进行剂量管理（辐射/ICM 减少）。
