Digital subtraction angiography of the abdominal aorta and lower extremities: carbon dioxide versus iodinated contrast material.
OBJECTIVE
To compare the diagnostic value of carbon dioxide to that of iodinated contrast material for digital subtraction angiography of the abdominal aorta and lower extremities.


METHODS
Thirty-five patients underwent comparative CO2 and iodinated contrast material arteriography of the abdominal aorta and lower extremities. For each contrast study, three independent observers evaluated the degree of opacification and percentage of stenosis of each vessel, the degree of certainty of their observations, and the overall quality of the study. Data of CO2 and iodinated studies were compared using analysis of variance for repeated measures. Interobserver and intertechnique agreements were estimated with Cohen's kappa and intraclass correlation coefficient.


RESULTS
Iodine-based vascular opacification was superior to that with CO2 in the central and distal arteries (P = .02). The degree of certainty and overall quality score were higher for iodine than for CO2-based contrast studies (P = .00001). The interobserver agreement for categorizing stenoses was higher for iodine as compared to CO2-based angiography. No significant difference was observed between the mean stenosis values obtained with CO2 and iodine-based angiography in any segment. Intraclass correlation coefficient demonstrated a high degree of convergence of the two techniques for assessing the percentage of stenosis.


CONCLUSIONS
CO2 can be used as an alternative to iodinated contrast material for obtaining arteriograms of the abdominal aorta and lower extremities for investigating atherosclerotic disease.
Department of Radiology, CHUM, Montreal, Canada.
V L
VL
Oliva
N
N
Denbow
E
E
Thérasse
A A
AA
Common
C
C
Harel
M F
MF
Giroux
G
G
Soulez
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015901:Angiography, Digital Subtraction; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000000981:diagnostic imaging; D002245:Carbon Dioxide; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D016037:Single-Blind Method; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D002245:Carbon Dioxide; C054871:ioversol