Digital subtraction angiography is a medical imaging technique that uses a reference photograph to subtract anatomical structures and show blood vessels. It can identify malformations, occlusions, and other problems. It is commonly used for skull angiograms and requires properly maintained equipment and trained technicians. Patients should ask for more information and additional steps may be required depending on the results.
Digital subtraction angiography (DSA) is a medical imaging technique used to show blood vessels in areas of dense tissue or bone. Vessels can be difficult to see with other anatomical structures in the way they are subtracted from the final image using a reference photograph taken at the start of the test. This allows healthcare professionals to clearly see the involved vessels so they can identify malformations, occlusions and other problems that may be difficult to pinpoint. The test can take place in a hospital or imaging clinic and can be an outpatient procedure.
Skull angiograms are common candidates for digital subtraction angiography because it can be difficult to see blood vessels in the brain with bone in the way. The test begins with an image to capture all the structures in the area of interest before a technician injects a contrast agent. A series of images is taken to follow the dye as it moves through the blood vessels. Digital processing with a computer can remove background bone and tissue, leaving behind a sharp image of blood vessels.
The level of image sharpness can depend on the age of the equipment and the processing program. This is a form of fluoroscopy, real-time X-ray imaging, and image quality can be highly variable. Properly maintained equipment operated by experienced technicians is more likely to provide clear, usable images, especially if the technician tests frequently.
This is only one option for examining blood vessels and may not be the first choice, depending on why your doctor wants an imaging study and the technology available. Digital subtraction angiography requires some basic equipment that may be available in many facilities, as opposed to more expensive imaging supplies that are only installed in large hospitals and imaging centers. Proper test administration also requires some training in correctly positioning the patient, selecting the appropriate contrast agents, and monitoring the procedure to ensure it is generating useful images.
When a doctor recommends digital subtraction angiography, patients can ask for more information. They may want to know why testing is required and what additional steps may be required. For example, if digital subtraction angiography reveals a vascular malformation, the patient may need magnetic resonance imaging of the skull to provide more information. This may require a trip to another imaging center if a hospital does not have the technology available.
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