Comparison of DSA and nonselective pulmonary angiography for the evaluation of resectability

We compared the diagnostic value of nonselective pulmonary angiography (NS-PAG) and pulmonary digital subtraction angiography (DSA-PAG) for evaluating resectability in cases of respiratory disease. Thirty-eight patients with pulmonary disease who were scheduled for thoracotomy were evaluated; among them, 35 had lung cancer. Of these 35 patients, chest X-ray or some other examination revealed hilar involvement in 13, and 32 were subsequently operated on. Of the entire 38 patients, 22 were evaluated using both methods. In DSA-PAG, 20 ml of contrast medium was rapidly injected through a basilic vein. In NS-PAG, 1.5 ml/kg of contrast medium was injected via the same route. For both methods, angiograms were taken by the pulmonary artery root, main PA root, pulmonary vein root and left atrium. DSA-PAG was shown to be superior to angiograms of the pulmonary vein root and the left atrium, especially in patients with atelectasis. It was difficult for DSA-PAG to detect delayed filling because of its small image field. NS-PAG enabled us to obtain wide-ranging information and was useful in attempts to assess both anatomical and functional indications for subsequent surgical procedures. (author)