Sumner D S, Porter D J, Moore D J, Winders R E
J Vasc Surg. 1985 Mar;2(2):344-53.
As experience with digital subtraction angiography (DSA) increases, both its advantages and disadvantages have become more evident. Although the intravenous approach (IV-DSA) is safer and less expensive than conventional arteriography, images are frequently suboptimal. Good-quality IV-DSAs quite accurately detect hemodynamically significant lesions (sensitivity 92% and specificity 92%) but may overlook minor stenoses and wall irregularities (negative predictive value 69%). When fine detail is not required, IV-DSA may serve as the definitive radiographic examination. The intra-arterial approach (IA-DSA), which provides better images, uses less contrast medium, decreases the need for selective catheterization, and permits visualization of vessels in areas of sluggish flow, is being used more extensively. Careful consideration of the complementary roles of DSA, conventional arteriography, and noninvasive testing is necessary to provide accurate diagnostic information at the least hazard and expense to the patient.
随着数字减影血管造影（DSA）经验的增加，其优缺点变得更加明显。尽管静脉途径（IV-DSA）比传统动脉造影更安全、成本更低，但图像质量常常欠佳。高质量的IV-DSA能相当准确地检测出具有血流动力学意义的病变（敏感性92%，特异性92%），但可能会忽略轻度狭窄和管壁不规则（阴性预测值69%）。当不需要精细细节时，IV-DSA可作为确定性的放射学检查。动脉内途径（IA-DSA）能提供更好的图像，使用的造影剂更少，减少了选择性插管的需求，并能显示血流缓慢区域的血管，其应用越来越广泛。为了以对患者最小的风险和费用提供准确的诊断信息，有必要仔细考虑DSA、传统动脉造影和无创检查的互补作用。
