Digital angiographic measurement of radiographic contrast material kinetics for estimation of myocardial perfusion
作者:
JAMES WHITING,
J. DRURY,
J. PFAFF,
BING CHANG,
NEAL EIGLER,
SAM MEERBAUM,
ELIOT CORDAY,
THASSANA NIVATPUMIN,
JAMES FORRESTER,
H. J. C. SWAN,
期刊:
Circulation
(OVID Available online 1986)
卷期:
Volume 73,
issue 4
页码: 789-798
ISSN:0009-7322
年代: 1986
出版商: OVID
数据来源: OVID
摘要:
ABSTRACTWe studied the use of digital angiography for the quantification of regional myocardial perfusion in the dog using selective left coronary arterial injection of radiographic contrast material as a flow dilution indicator. We developed algorithms for generating time-intensity curves from regions of interest over the proximal coronary artery and the myocardium and for densitometric error correction by subtraction of the intensity curve over a small lead blocker before logarithmic transformation. The resultant myocardial time-density curves were analyzed for time from injection to peak concentration (TPC) and for exponential washout rate (k). A linear correlation was found between absolute coronary arterial blood flow and both k (slope = 0.13, r = .85) and 1/TPC (slope = 0.18, r = .85). Reproducibility of TPC and k for repeated studies was 11% and 16%. Induced hyperemia significantly improved the sensitivity to stenosis by increasing the average difference in TPC and k between regions served by normal and stenotic coronary arteries to 65% and 80%, respectively. By combining selective coronary arterial injection with the left lateral x-ray projection it was possible to avoid most overlap of regional perfusion beds in the dog. This study suggests that contrast dilution measurements made during digital coronary angiography provide a means for assessing the hemodynamic significance of stenoses and the efflcacy of therapeutic interventions.
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