Technical note: inspiration or expiration? Reducing motion artefact in digital subtraction arch angiography of the extracranial carotid arteries

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Radiology

Background:

• Carotid bifurcation disease diagnosis relies on high-quality imaging.
• Digital subtraction angiography is a key imaging modality.
• Respiration can artifact image acquisition.

Purpose of the Study:

• To evaluate the impact of respiration phase on digital subtraction aortic arch angiography quality.
• To determine if suspending respiration in expiration improves image quality compared to inspiration.

Main Methods:

• 100 patients with suspected carotid bifurcation disease underwent digital subtraction aortic arch angiography.
• Patients were randomized to suspend respiration in either inspiration or expiration.
• Angiograms were qualitatively assessed for image quality.

Main Results:

• Images acquired during expiration suspension showed significantly higher quality scores (p=0.038).
• Expiration group had 53% excellent images vs. 29% in inspiration group.
• Use of pixel shifting was significantly reduced in the expiration group (p=0.0012).

Conclusions:

• Suspending respiration in expiration during aortic arch angiography improves image quality.
• This technique enhances diagnostic confidence and reduces the need for post-processing.
• The method is cost-effective and time-efficient.