title: Development of a theory for generating regional cardiac perfusion images during coronary angiography in the coronary angiography lab.
abstract: The purpose of this study was to develop a novel theory and method for generating regional myocardial perfusion images using fluoroscopy in the coronary angiography lab. We modified the Kety model to introduce the Patlak plot method for two-dimensional fluoroperfusion (FP) imaging. For evaluation, seven porcine models of myocardial ischemia with stenosis in the left coronary artery were prepared. Rest and stress FP imaging were performed using cardiovascular X-ray imaging equipment during the injection of iopamidol via the left main coronary artery. Images were acquired and retrospectively ECG gated at 80 % of the R-R interval. FP myocardial blood flow (MBF) was obtained using the Patlak plot method applied to time-intensity curve data of the proximal artery and myocardium. The results were compared to microsphere MBF measurements. Time-intensity curves were also used to generate color-coded FP maps. There was a moderate linear correlation between the calculated FP MBF and the microsphere MBF (y = 0.9758x + 0.5368, R² = 0.61). The color-coded FP maps were moderately correlated with the regional distribution of flow. This novel method of first-pass contrast-enhanced two-dimensional fluoroscopic imaging can quantify MBF and provide color coded FP maps representing regional myocardial perfusion.
authors.forename: Takuya
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichihara
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Trost
authors.forename: Omair
authors.initials: O
authors.lastname: Yousuf
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Jingwu
authors.initials: J
authors.lastname: Yao
authors.forename: Richard T
authors.initials: RT
authors.lastname: George
mesh_terms: D000818:Animals; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004195:Disease Models, Animal; D004562:Electrocardiography; D005471:Fluoroscopy; D007479:Iopamidol; D016014:Linear Models; D008955:Models, Cardiovascular; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D013552:Swine; D013997:Time Factors
chemical_list: D003287:Contrast Media; D007479:Iopamidol