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[New developments in parameter-oriented roentgen densitometry perfusion analysis within the scope of heart catheter
M Haude1, G Caspari, D Baumgart
1Abteilung für Kardiologie, Universität-GHS Essen.
Herz
|April 1, 1997
Summary
X-ray densitometry of coronary arteriograms quantifies myocardial perfusion reserve. This technique, now feasible for routine cardiac catheterization, shows improved perfusion after stenting.
Area of Science:
- Cardiovascular imaging
- Medical physics
- Interventional cardiology
Background:
- X-ray densitometry of digital subtraction coronary arteriograms enables contrast medium propagation analysis.
- Time-density curves (TDCs) derived from contrast medium can assess myocardial perfusion.
- Previous limitations included time-consuming evaluation and inability to measure absolute flow.
Purpose of the Study:
- To evaluate the feasibility and accuracy of an improved X-ray densitometric approach for assessing myocardial perfusion reserve.
- To validate the technique against microsphere methods and assess its utility in routine cardiac catheterization.
- To document the functional benefits of coronary interventions on myocardial perfusion.
Main Methods:
- Generating TDCs from digital subtraction coronary arteriograms using contrast medium as an indicator.
- Calculating myocardial perfusion reserve by comparing hyperemic to baseline flow.
- Utilizing advanced software for automated digitization, region-of-interest definition, and parameter analysis.
- Validating the "rise time" parameter against color-coded microsphere techniques in animal studies.
Main Results:
- The improved X-ray densitometric approach demonstrated a strong correlation (r2 = 0.965) with microsphere techniques for myocardial perfusion.
- Post-stenotic myocardial perfusion reserve significantly improved immediately after balloon angioplasty and further after adjunct stenting.
- Coronary stenting, unlike balloon angioplasty alone, consistently restored post-stenotic myocardial perfusion reserve to intraindividual reference levels.
Conclusions:
- X-ray densitometry, enhanced by modern computing power and software, is now a feasible method for assessing myocardial perfusion reserve during routine cardiac catheterization.
- The technique provides valuable functional information, complementing morphological assessments of coronary interventions.
- Coronary stenting offers significant functional benefits by improving post-stenotic myocardial perfusion reserve.