LOWER-EXTREMITY - NONSTEPPING DIGITAL ANGIOGRAPHY WITH PHOTOSTIMULABLE IMAGING PLATES VERSUS CONVENTIONAL ANGIOGRAPHY

PURPOSE: To compare nonstepping digital subtraction angiography (DSA) (ie, storage phosphor radiography adapted to a stationary imaging plat e changer) with conventional screen-film angiography in the evaluation of the lower extremities. MATERIALS AND METHODS: Fifty-one patients w ith peripheral vascular disease underwent both nonstepping DSA and scr een-film angiography. The angiographic and radiologic techniques of bo th systems were kept identical for each patient. Three radiologists in dependently rated the overall quality of each angiogram. In their eval uations for each of 12 arterial segments on all 102 angiograms, they a lso rated the degree of opacification, the diameter reduction of the m ost severe stenosis, and their level of confidence. RESULTS: Mean over all quality scores and levels of confidence were better for nonsteppin g DSA than for screen-film angiography (P < .001>. Full opacification was reported in 95.6% and 89.2% of all 1,836 segments with nonstepping DSA and screen-film angiography, respectively (P < .0001). The differ ence between the mean stenosis grades obtained with screen-film angiog raphy and nonstepping DSA was not statistically significant. Intertech nique agreements were good (kappa = 0.77, 0.81, and 0.81), whereas int erobserver agreements were influenced by the observer's experience wit h the imaging techniques. CONCLUSION: Nonstepping DSA images of the lo wer extremity were of better diagnostic quality than were screen-film angiograms. The development of dedicated nonstepping DSA equipment is warranted.