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Ir Midterm

The document discusses techniques for subtraction angiography including photographic and digital subtraction. It describes the components and process for manual subtraction including zero films, reversal films, and different subtraction techniques like first and second order subtraction. Digital subtraction angiography techniques are also covered.

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John Engelbert Acero
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43 views4 pages

Ir Midterm

The document discusses techniques for subtraction angiography including photographic and digital subtraction. It describes the components and process for manual subtraction including zero films, reversal films, and different subtraction techniques like first and second order subtraction. Digital subtraction angiography techniques are also covered.

Uploaded by

John Engelbert Acero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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IR

Subtraction angiography
- Technique by which bone structure image is subtracted or cancelled out from the film
of bones and opacified vessels, leaving an unobsured image of the vessels
- Performed either electronically (manual) or photographically (digital)
Photographic subtraction
- Introduced by ziedses des plantes
- Manual subtraction technique
Rapid several film changers
- Uses because flow of blood in the vessels is extremely fast
- Exposes several radiograph in 1 seconds
- Required in recording the arterial, capillary, and venous phase of the cardiovascular
system
Supply magazine
- Light tight box filled with film in the darkroom and then attached to the film changer
- Can store at least 12 unexposed films
Transport mechanism
- Composed of compression roller devices that moves the film from the supply
magazine to a pair of intensifying screen and then receiving cassette
Compression table
- Contains a pair of intensifying screens and compression plate
- Compresses the film when it is position between them
- Releases the film when exposure is complete then it will advance to the receiving
cassettes.
Receiving cassette
- Magazine that holds the exposed film
Zero film / base film / control film
- Film showing bone structures only
- Exposed before injection of contrast media
- Initial film
- White tone
Reversal film / mask film
- Reverse tone duplicate of radiographic film
- White to black tone
- Needs zero film
Series film
- Radiographic image obtained with the contrast media induced to the vessel
- Have contrast media
Registration
- Matching one image to another so that bony landmarks are precisely superimposed
- Final output
Single emulsion film
- Used in subtraction angiography
Manual subtraction techniques
- First order subtraction
- Second order subtraction
- Composite mark subtraction
First order subtraction
1. Take base film (zero film)
2. Obtain reversal or mask film (darkroom) (5 secs)
3. Take series film (with contrast)
4. Register mask film and series film together
5. Make final subtracted image (5-20 secs)
Second order subtraction
- The reversal of scout film obtained in the first order subtraction is not usually not the
exact reversal of the density
- Introduced by hanafee and shinno

1. take base film


2. obtain reversal or mask film
3. register reversal or mask film and zero film together
4. obtain secondary or correction mask (darkroom) (20 secs)
5. take series film and process it (with contrast)
6. register mask film, second order mask, and series film together
7. make final subtracted image (35 secs)
Composite mask subtraction
- white over white technique
- introduced by sucher and strand in 1974
- almost totally eliminates both bony structures and soft tissues level, leaving a display
of vessels in high contrast reproduction

1. take zero film


2. obtain reversal or mask film (expose 5 secs)
3. .
4. .
5. Register series reversal film and zero film
6. Make secondary film (20 secs)
7. Register series film, mask film, and secondary film together (35 secs)

Advantages of digital over conventional fluoroscopy


- Speed of image acquisition
- Post processing to enhance image contrast
- Small size anatomical structures are more visualized
Digital subtraction angiography
- Computer assisted radiographic technique of visualizing blood vessels with a minimal
view of background tissues

- Image matrix size


- System dynamic range
- Image acquisition rate
Image formation
- Square or rectangular shaped x ray beam
- Reduces image contrast
Digital subtraction techniques
1. Temporal subtraction
2. Energy subtraction
3. Hybrid subtraction
Mask mode temporal subtraction
- Most closely resembles manual subtraction angiography
- Early images acts as the mask which is subtracted from the rest of the images taken by
later
- Results in the successive subtraction images of contrast filled vessels
Hybrid subtraction
- Combination of temporal and energy subtraction

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