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Digital cine angiographic evaluation of pulmonary blood flow velocity in ventricular septal defect
G Riediger1, L M Grävinghoff, K H Höhne
1Institute for Mathematics and Data Processing in Medicine, Hamburg, FRG.
Insights
Digital image processing of ventricular septal defect (VSD) cineangiograms reveals pulmonary blood flow changes. Reduced contrast arrival time indicates increased flow, while increased time suggests higher resistance in VSD patients.
Area of Science:
- Pediatric Cardiology
- Medical Imaging Analysis
- Hemodynamics
Background:
- Ventricular septal defect (VSD) can lead to altered pulmonary blood flow.
- Assessing pulmonary hemodynamics is crucial for VSD management.
- Traditional methods may not fully capture dynamic flow changes.
Purpose of the Study:
- To extract functional pulmonary blood flow information from VSD cineangiograms.
- To quantify contrast bolus arrival time in pediatric VSD patients.
- To correlate arrival time with shunt severity and pulmonary vascular resistance.
Main Methods:
- Analysis of 41 right ventricular cineangiograms using digital image processing.
- Measurement of contrast bolus arrival time from pulmonary artery to peripheral lung fields.
- Calculation of mean arrival time in three lung points (apex, horizontal, basis).
Main Results:
- Normal pulmonary blood flow showed an arrival time of 1.3 ± 0.3 seconds.
- VSD with increased left-to-right shunt demonstrated a decreased arrival time of 0.76 ± 0.2 seconds.
- Increased pulmonary vascular resistance led to an increased arrival time of 1.4 ± 0.4 seconds.
Conclusions:
- Contrast arrival time is a sensitive indicator of pulmonary blood flow in VSD.
- This imaging technique can differentiate between increased flow and increased resistance.
- Digital analysis of cineangiograms offers valuable functional hemodynamic insights for VSD.
Abstract:
Forty-one routine right ventricular cineangiograms of children with ventricular septal defect (VSD) were evaluated with a digital image processing system. The purpose was to extract from the cineangiogram functional images that would provide information about pulmonary blood flow in these patients. The time delay of the contrast bolus between the main pulmonary artery and peripheral lung fields was measured and called "arrival time." By measuring the arrival time in three different points of each lung (apex, horizontal, basis), it was possible to express the mean arrival time for both lungs in a single figure. A group of patients without heart disease showed an arrival time of 1.3 +/- 0.3 seconds. In VSD with increased pulmonary blood flow from the left to right shunt, the arrival time decreased to 0.76 +/- 0.2 seconds. An increase in pulmonary vascular resistance with reduced L-R shunt led to an increased arrival time of 1.4 +/- 0.4 seconds.