title: Intravascular ultrasound versus digital subtraction angiography: direct comparison of intraluminal diameter measurements in pediatric and adolescent imaging.
abstract: BACKGROUND
  Intravascular ultrasound (IVUS) allows intraluminal imaging of blood vessels rather than the one-dimensional luminal outline depicted by digital subtraction angiography (DSA). Despite extensive literature in multiple adult vascular diseases, IVUS has not been directly compared to DSA in pediatric and adolescent vascular pathologies.
  
  
  OBJECTIVE
  The purpose of this manuscript is to compare absolute luminal diameter measurements obtained via IVUS and DSA during a variety of pediatric endovascular procedures.
  
  
  METHODS
  We conducted a retrospective review of all pediatric and adolescent endovascular procedures from October 2014 to March 2016 in which IVUS and DSA were used. We compared the vessel diameter measurements and analyzed them using SAS software with a paired t-test.
  
  
  RESULTS
  There were 102 total measurements (DSA = 56; IVUS = 56; 22 procedures; 20 patients). On average, IVUS measured 0.6 ± 2.1 mm larger than DSA (95% confidence interval [CI] -0.01 to 1.12; P = 0.06; r = 0.90). When venous compression syndrome (May-Thurner, Nutcracker, superior vena cava syndrome) measurements were excluded, IVUS measured 0.7 ± 1.6 mm larger than DSA (95% CI 0.14 to 1.18; P = 0.01; r = 0.93). When venous compression syndrome measurements were evaluated separately, IVUS measured 0.3 ± 3.0 mm larger than DSA (95% CI -1.16 to 1.82; P = 0.65; r = 0.45).
  
  
  CONCLUSIONS
  Overall, IVUS measurements were slightly larger than DSA measurements in all data subsets. Absolute vessel diameter measurements obtained with IVUS in the pediatric and adolescent population are statistically significantly larger than those obtained using DSA when excluding venous compression syndromes. In venous compression syndromes, IVUS might provide a more accurate representation of vessel compression and diameter than DSA.
authors.affiliation: Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-guided Medicine, Emory University School of Medicine, 1364 Clifton Road NE, Suite D 112, Atlanta, GA, 30322, USA. anne.gill@emory.edu.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Gill
authors.affiliation: Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-guided Medicine, Emory University School of Medicine, 1364 Clifton Road NE, Suite D 112, Atlanta, GA, 30322, USA.
authors.forename: Tadi
authors.initials: T
authors.lastname: Ciszak
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA.
authors.forename: Hayley
authors.initials: H
authors.lastname: Braun
authors.affiliation: Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-guided Medicine, Emory University School of Medicine, 1364 Clifton Road NE, Suite D 112, Atlanta, GA, 30322, USA.
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Hawkins
mesh_terms: D000293:Adolescent; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001808:Blood Vessels / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*; D014652:Vascular Diseases / Q000000981:diagnostic imaging*
keywords: Children; Digital subtraction angiography; Intravascular ultrasound; Measurement; Venous compression syndromes