Intraarterial digital subtraction arteriography in the diagnosis and treatment of hepatic tumors.
Intraarterial digital subtraction arteriography (IADSA) was performed in 94 patients with hepatic tumors and evaluated on the following subjects: 1) visualization of small arteries in arterial phase, compared with film study, 2) visualization of faint tumor stains in hepatogram phase, compared with film study, 3) visualization of portal venous branches by intraarterial digital subtraction portography (IADSP). Interventional angiography was performed in 76 patients. Contrast dose and injection rate of IADSA was approximately a third of film study without dilution. The position of the catheter was identical in IADSA and film study. IADSPs were performed with 15-20 ml of 76% Urografin, which was injected into the superior mesenteric artery at the rate of 5 ml/sec after infusion of prostaglandin E1. Comparison in arterial phase of 67 patients showed 24 (36%) IADSAs were equal to film study. Thirty-nine (58%) were inferior but adequate for the diagnosis of hepatic tumors. Comparison in hepatogram phase showed 24 (38%) IADSAs were superior to film study and all were satisfactory for the diagnostic purposes. Ninety-eight percent of 86 IADSPs gave information about the patency of the main portal vein. Fifty-five percent of IADSPs opacified third-order portal vein branches or further. IADSA of hepatic tumors not only save time and contrast dose but was also satisfactory in image quality for interventional angiography.
D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013382:Subtraction Technique