Digital angiographic measurement of radiographic contrast material kinetics for estimation of myocardial perfusion.
Digital angiographic measurement of radiographic contrast material kinetics for estimation of myocardial perfusion.
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用于估计心肌灌注的放射造影材料动力学的数字血管造影测量。
DOI：
10.1161/01.cir.73.4.789
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发表时间：
1986
期刊：
影响因子：
37.8
通讯作者：
Swan,HJ
中科院分区：
文献类型：
--
作者：
Whiting,JS;Drury,JK;Pfaff,JM;Chang,BL;Eigler,NL;Meerbaum,S;Corday,E;Nivatpumin,T;Forrester,JS;Swan,HJ
我们研究了使用选择性左冠状动脉注射放射造影剂作为血流稀释指示剂的数字血管造影术定量犬的局部心肌灌注。我们开发了算法，用于从近端冠状动脉和心肌上的感兴趣区域生成时间-强度曲线，并通过在对数变换之前减去小铅阻断剂上的强度曲线来进行密度误差校正。分析所得心肌时间-密度曲线的注射至峰浓度的时间（TPC）和指数洗脱率（k）。发现绝对冠状动脉血流量与k（斜率= 0.13，r = 0.85）和1/TPC（斜率= 0.18，r = 0.85）之间呈线性相关。重复研究的TPC和k的重现性分别为11%和16%。诱导充血显著提高了狭窄的敏感性，增加了正常和狭窄冠状动脉之间的TPC和k的平均差异分别为65%和80%。通过将选择性冠状动脉注射与左侧X线投影相结合，可以避免犬中区域灌注床的大部分重叠。这项研究表明，数字冠状动脉造影术期间进行的对比稀释测量提供了一种评估狭窄的血流动力学意义和治疗干预有效性的方法。
We 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 efficacy of therapeutic interventions.