Development of a theory for generating regional cardiac perfusion images during coronary angiography in the coronary angiography lab

Takuya Sakaguchi, Takashi Ichihara, Jeffrey C. Trost, Omair Yousuf, Joao A.C. Lima, Jingwu Yao, Richard T. George

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)9-19
Number of pages11
JournalInternational Journal of Cardiovascular Imaging
Volume30
Issue number1
DOIs
StatePublished - Jan 2014

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Keywords

  • Compartment model
  • Coronary angiography
  • Kety model
  • Myocardium
  • Perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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