title: Quantitative Perfusion Analysis of First-Pass Contrast Enhancement Kinetics: Application to MRI of Myocardial Perfusion in Coronary Artery Disease.
abstract: OBJECTIVE
  Perfusion analysis from first-pass contrast enhancement kinetics requires modeling tissue contrast exchange. This study presents a new approach for numerical implementation of the tissue homogeneity model, incorporating flexible distance steps along the capillary (NTHf).
  
  
  METHODS
  The proposed NTHf model considers contrast exchange in fluid packets flowing along the capillary, incorporating flexible distance steps, thus allowing more efficient and stable calculations of the transit of tracer through the tissue. We prospectively studied 8 patients (62 ± 13 years old) with suspected CAD, who underwent first-pass perfusion CMR imaging at rest and stress prior to angiography. Myocardial blood flow (MBF) and myocardial perfusion reserve index (MPRI) were estimated using both the NTHf and the conventional adiabatic approximation of the TH models. Coronary artery lesions detected at angiography were clinically assigned to one of three categories of stenosis severity ('insignificant', 'mild to moderate' and 'severe') and related to corresponding myocardial territories.
  
  
  RESULTS
  The mean MBF (ml/g/min) at rest/stress and MPRI were 0.80 ± 0.33/1.25 ± 0.45 and 1.68 ± 0.54 in the insignificant regions, 0.74 ± 0.21/1.09 ± 0.28 and 1.54 ± 0.46 in the mild to moderate regions, and 0.79 ± 0.28/0.63 ± 0.34 and 0.85 ± 0.48 in the severe regions, respectively. The correlation coefficients of MBFs at rest/stress and MPRI between the NTHf and AATH models were r = 0.97/0.93 and r = 0.91, respectively.
  
  
  CONCLUSIONS
  The proposed NTHf model allows efficient quantitative analysis of the transit of tracer through tissue, particularly at higher flow. Results of initial application to MRI of myocardial perfusion in CAD are encouraging.
authors: Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, NY, 10016, United States of America.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: Sohae
authors: http://orcid.org/0000-0002-1132-900X
authors: S
authors: Chung
authors: Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: Binita
authors: B
authors: Shah
authors: Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, NY, 10016, United States of America.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: Pippa
authors: P
authors: Storey
authors: Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: Sohah
authors: S
authors: Iqbal
authors: Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: James
authors: J
authors: Slater
authors: Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, NY, 10016, United States of America.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, 10016, United States of America.
authors: Leon
authors: L
authors: Axel
mesh_terms: D000368:Aged; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003326:Coronary Circulation; D006801:Humans; D007700:Kinetics; D008279:Magnetic Resonance Imaging; D008297:Male; D008954:Models, Biological; D055414:Myocardial Perfusion Imaging
chemical_list: D003287:Contrast Media