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Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images.

Molloi S, Chalyan D, Le H, Wong JT - Int J Cardiovasc Imaging (2011)

Bottom Line: Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min).The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min).This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, University of California, Medical Sciences B, B-140, Irvine, CA 92697, USA. symolloi@uci.edu

ABSTRACT
The purpose of this study is to develop a method to estimate the hyperemic blood flow in a coronary artery using the sum of the distal lumen volumes in a swine animal model. The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions where it is difficult to determine whether a particular lesion is the cause of ischemia. Therefore, a functional measure of stenosis severity is needed using angiographic image data. Coronary arteriography was performed in 10 swine (Yorkshire, 25-35 kg) after power injection of contrast material into the left main coronary artery. A densitometry technique was used to quantify regional flow and lumen volume in vivo after inducing hyperemia. Additionally, 3 swine hearts were casted and imaged post-mortem using cone-beam CT to obtain the lumen volume and the arterial length of corresponding coronary arteries. Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min). The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min). These results indicate that measured arterial branch lengths or lumen volumes can potentially be used to predict the expected hyperemic flow in an arterial tree. This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

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Coronary angiogram with a global ROI superimposed over the LAD coronary artery for blood flow measurement
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Fig4: Coronary angiogram with a global ROI superimposed over the LAD coronary artery for blood flow measurement

Mentions: Flow measurements were made using a first pass analysis technique, which models the arterial volume compartment supplied by a major coronary artery as a reservoir with a single input. The model does not require any assumptions regarding the internal structure of the arterial volume compartment or the nature of the exit conduits. Instead, the necessary assumptions are that (1) the flow measurement is performed before the contrast material begins to exit the volume compartment (which includes microvessels) and (2) the input contrast concentration is known during the flow measurement period. Figure 4 shows a coronary arteriogram with a global ROI used for blood flow measurement. A global ROI, which includes the myocardial blush, is particularly important for flow measurement at hyperemia where the transit time within the epicardial arteries is relatively short. An arterial ROI (see Fig. 3) is adequate for flow measurement at baseline but will underestimate the flow at hyperemia.Fig. 4


Estimation of coronary artery hyperemic blood flow based on arterial lumen volume using angiographic images.

Molloi S, Chalyan D, Le H, Wong JT - Int J Cardiovasc Imaging (2011)

Coronary angiogram with a global ROI superimposed over the LAD coronary artery for blood flow measurement
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3094746&req=5

Fig4: Coronary angiogram with a global ROI superimposed over the LAD coronary artery for blood flow measurement
Mentions: Flow measurements were made using a first pass analysis technique, which models the arterial volume compartment supplied by a major coronary artery as a reservoir with a single input. The model does not require any assumptions regarding the internal structure of the arterial volume compartment or the nature of the exit conduits. Instead, the necessary assumptions are that (1) the flow measurement is performed before the contrast material begins to exit the volume compartment (which includes microvessels) and (2) the input contrast concentration is known during the flow measurement period. Figure 4 shows a coronary arteriogram with a global ROI used for blood flow measurement. A global ROI, which includes the myocardial blush, is particularly important for flow measurement at hyperemia where the transit time within the epicardial arteries is relatively short. An arterial ROI (see Fig. 3) is adequate for flow measurement at baseline but will underestimate the flow at hyperemia.Fig. 4

Bottom Line: Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min).The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min).This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, University of California, Medical Sciences B, B-140, Irvine, CA 92697, USA. symolloi@uci.edu

ABSTRACT
The purpose of this study is to develop a method to estimate the hyperemic blood flow in a coronary artery using the sum of the distal lumen volumes in a swine animal model. The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions where it is difficult to determine whether a particular lesion is the cause of ischemia. Therefore, a functional measure of stenosis severity is needed using angiographic image data. Coronary arteriography was performed in 10 swine (Yorkshire, 25-35 kg) after power injection of contrast material into the left main coronary artery. A densitometry technique was used to quantify regional flow and lumen volume in vivo after inducing hyperemia. Additionally, 3 swine hearts were casted and imaged post-mortem using cone-beam CT to obtain the lumen volume and the arterial length of corresponding coronary arteries. Using densitometry, the results showed that the stem hyperemic flow (Q) and the associated crown lumen volume (V) were related by Q = 159.08 V(3/4) (r = 0.98, SEE = 10.59 ml/min). The stem hyperemic flow and the associated crown length (L) using cone-beam CT were related by Q = 2.89 L (r = 0.99, SEE = 8.72 ml/min). These results indicate that measured arterial branch lengths or lumen volumes can potentially be used to predict the expected hyperemic flow in an arterial tree. This, in conjunction with measured hyperemic flow in the presence of a stenosis, could be used to predict fractional flow reserve based entirely on angiographic data.

Show MeSH
Related in: MedlinePlus