Here is C# code that demonstrates how to add digital signature with image appearance to a PDF document: 
using System.Drawing;
using System.Security.Cryptography.X509Certificates;
using Vintasoft.Imaging.Pdf;

/// <summary>
/// Adds digital signature with image appearance to a PDF page.
/// </summary>
public class PdfPageDigitalSignatureHelper_ImageAppearance
{
    public static void Run()
    {
        // get the X509 certificate from .pfx-file
        using (X509Certificate2 certificate = new X509Certificate2("TestCertificate.pfx", "test"))
        {
            // create a helper that alows to add digital signature to a PDF document
            PdfPageDigitalSignatureHelper digitalSignatureHelper =
                new PdfPageDigitalSignatureHelper(certificate, new RectangleF(20, 20, 250, 100));

            // set signature information
            digitalSignatureHelper.SignerName = "Mr. X";
            digitalSignatureHelper.SigningReason = "Approval";
            digitalSignatureHelper.SigningLocation = "My Location";
            digitalSignatureHelper.SignerContactInfo = "Phone: 9999-123-45-67";

            // set the name of image file that defines the signature appearance
            digitalSignatureHelper.SignatureImageFilename = "SignatureImage.svg";

            // add digital signature to the first PDF page, sign PDF document and save PDF document to the output file
            digitalSignatureHelper.SignDocument("TestDocumentToSign.pdf", "TestDocumentToSign-signed.pdf", 0);
        }
    }
}