Comparison of Nonsubtracted Digital Angiography and Conventional Screen-Film Angiography for the Evaluation of Patients with Peripheral Vascular Disease

Recently, x-ray equipment manufacturers have produced systems capable of generating nonsubtracted digital angiograms (NSDA) of the arteries of the lower extremities with a high-resolution 1,024 x 1,024 matrix. One such system was compared with conventional screen-film angiography (CSFA) for the evaluation of peripheral vascular disease. Both NSDA and CSFA were performed prospectively in an identical fashion on 47 patients. The images were evaluated, and diagnostic adequacy (ie, information sufficient to direct subsequent therapy) and a variety of image quality attributes--vessel opacification, correct timing, complete anatomic coverage, and ease of reading--were compared. CSFA and NSDA provided similar diagnostic information. NSDA was judged superior to CSFA with regard to timing (P less than .001). CSFA was judged superior with regard to anatomic coverage (P less than .001) and ease of reading (P less than .01). NSDA is a promising method for evaluating patients with peripheral vascular disease. Further work is needed to provide more complete anatomic coverage and to improve the quality of the hard-copy images.