Hoffman M G, Gomes A S, Pais S O
AJR Am J Roentgenol. 1984 Feb;142(2):261-4. doi: 10.2214/ajr.142.2.261.
To evaluate the limitations of intravenous carotid digital subtraction angiography (DSA) in the diagnosis of carotid disease, studies of 130 patients were reviewed. Factors that resulted in a nondiagnostic study included: (1) misregistration larynx artifact overlying the carotid bifurcation; (2) external carotid or vertebral artery overlying the internal carotid artery; and (3) poor arterial contrast density secondary to poor cardiac function. As a result of these limitations, the ideal of adequate demonstration of both carotid bifurcations in two opposite oblique projections or an oblique and anteroposterior projection was achieved in only 34 patients (26%). Of 126 carotid bifurcations that were seen adequately in two or more different projections, 19 (15%) showed an abnormality in one projection but appeared normal in another. These abnormalities would not have been detected had the vessel been visualized only in the spuriously normal-appearing projection. These and other limitations of intravenous DSA, such as contrast load and morbidity, are discussed.
为评估静脉注射法颈动脉数字减影血管造影（DSA）在颈动脉疾病诊断中的局限性，我们回顾了130例患者的研究资料。导致检查结果无法诊断的因素包括：（1）颈动脉分叉上方的喉错位伪影；（2）颈外动脉或椎动脉覆盖颈内动脉；（3）心功能差导致动脉对比剂密度低。由于这些局限性，仅在34例患者（26%）中实现了在两个相反斜位投影或一个斜位和一个前后位投影中充分显示双侧颈动脉分叉的理想情况。在126个在两个或更多不同投影中显示清晰的颈动脉分叉中，19个（15%）在一个投影中显示异常而在另一个投影中看似正常。如果仅在看似正常的投影中观察血管，这些异常就不会被发现。本文还讨论了静脉注射法DSA的这些及其他局限性，如对比剂负荷和发病率。
