Quantitative analysis of structure and function of the cardiovascular system by roentgen-video-computer techniques

A survey of the evolution of roentgen-video-computer techniques is given which was initiated by the development of videodensitometry by Wood and his associates. Following fundamental studies of the usefulness and limitations of x-ray equipment for quantitative measurements and the applicability of the Lambert-Beers law to x-ray absorption, videodensitometry has been used experimentally and clinically for various circulatory studies and has proved to be particularly valuable for the quantitation of aortic, pulmonic, and mitral valvular regurgitation. The second offspring of these techniques, so-called videometry, uses dimensional measurements from single and biplane angiocardiograms for the assessment of size, shape, and contraction pattern of the heart chambers. Volumes of the right and left ventricles can be determined clinically with a standard error of estimate below 10%. On the basis of these studies, normal values have been derived for all age groups, and they depict geometric changes of the growing heart. Cardiac index and ejection fractions proved to be age-independent biologic constants. Finally, methods for complete digital processing of video-image sequences in an off-line and real-time mode are described which allow digital image storage and documentation, dynamic background subtraction for contrast enhancement, and intravenous angiocardiography, in addition to functional imaging by parameter extraction from a matrix of pixel densitograms. Wall thickness and motion determinations, regional flow distribution measurements, and various image-composition techniques are also feasible.