Measurement of Regional Changes in Myocardial Perfusion Using Dynamic Computed Tomography and Contrast Medium

Pw, Doherty; Cg, Skiöldebrand; Rw, Redington; Wh, Berninger; Mj, Lipton

doi:10.1177/028418518302400404

Cited by 8 publications

(3 citation statements)

References 8 publications

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“…Measurement of absolute myocardial blood flow by ultrafast computed tomography (CT) has DIAGNOSTIC METHODS-RADIOLOGY The use of computed tomography in the heart has been limited by motion artifacts encountered with long image acquisition times. 8 In this study, we have used an Imatron C-100 CT scanner that acquires a pair of adjacent, cross-sectional images in 50 msec. This speed is produced by magnetically steering an electron beam to tungsten target rings as opposed to mechanically rotating an x-ray tube in conventional CT scanners.…”

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confidence: 99%

Measurement of myocardial blood flow by ultrafast computed tomography.

et al. 1987

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Myocardial blood flow was analyzed by radioisotope-labeled microspheres and ultrafast computed tomography (CT) in 16 closed-chest, anesthetized dogs. The first set of 10 dogs had CT and microsphere measurements before and after chromonar-induced increases in myocardial blood flow. A second set of six dogs had flows measured at control and during temporary reductions in regional flow produced by balloon cuff occlusion of the left anterior descending coronary artery. All dogs had four-slice, 20-instance CT scans after injection of a medium bolus (0.35 ml/kg) of contrast medium into a femoral vein simultaneous with injection of microspheres into the left atrium. CT myocardial flow was calculated as the change in myocardial CT numbers divided by the area from a blood pool time-density curve. A wide range of myocardial blood flows was produced as determined by microspheres (0 to 6.7 ml/min/g). Global flow of the first set of dogs was shown to have excellent correlation (r = .95, n = 17) for a limited range (.4 < X < 1.4 ml/min/g) of flows. Regional flows of these measurements demonstrated less correlation (r = .63, n = 110) but extended the range of flow to 1.7 ml/min/g. At higher flows (> 2.5 ml/min/g) the correlation for global and regional flows was not significantly different than zero. Regional ischemic flow correlation extended the linear range of flow to 0 ml/min/g (r = .62, n = 17). These results show that CT can measure myocardial blood flow over a limited but clinically relevant range of flows defined as slightly above normal to ischemic. These results indicate that another preparation of CT flow measurement must be sought for quantification of myocardial perfusion values significantly above normal. Circulation 76, No. 6, 1262-1273 MEASUREMENT of myocardial blood flow in man has been evaluated by the combination of cardiac imaging methods and a variety of indicators. This approach has been limited in the heart by the lack of an imaging modality that could acquire images with high temporal and spatial resolution and accurately measure the concentration of an indicator in the myocardium. Currently, the only clinically available method of measuring absolute myocardial blood flow is xenon

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confidence: 99%

Measurement of myocardial blood flow by ultrafast computed tomography.

et al. 1987

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“…Cine-CT scanning offers the additional possibility of measuring regional myocardial perfusion either by direct time-density measurements or by the application of functional analytic techniques (31,32,33). This would be of great diagnostic and prognostic value because myocardial perfusion is a dynamic physiologic parameter which summarizes the relationship between coronary obstruction and collateral flow.…”

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confidence: 99%

Computed axial tomography of the heart

1985

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CT scanning provides useful cardiac imaging but has not become a routine clinical tool for heart disease due to long exposure times (2-5 seconds) and the limitation of single slice acquisition. A revolutionary high speed (Cine) CT electron beam scanner was designed at UCSF, with multilevel millisecond scanning speed at rates of 17 scans per second. Table tilt and swivel permits direct imaging in various planes including the half axis view. Images can be analysed as closed loop movies, and quantitation of wall thickening, wall mass and ejection fractions are being validated. High resolution imaging without the need for gated acquisition is a significant advantage over nuclear medicine and magnetic resonance imaging, and physiology can be studied with exercise of other interventions. Fast CT can measure vessel blood flow and has great potential for estimating myocardial perfusion using indicator dilution theory and small peripheral intravenous injection of contrast medium. Cine CT could become the noninvasive modality of choice in cardiovascular diagnosis - the scanner has universal application for all organ systems.

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“…CT scanning has been used for quantitation of flow through phantoms (13). The ability of cr to estimate cardiac output, cerebral, myocardial and renal blood flow as well as relative blood flow in the liver have all been documented (2,10,15,20,(27)(28)(29)36). CT scanning has been used in addition to demonstrate cerebral (7), renal (37), and myocardial infarction (1).…”

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Attenuation Changes of the Normal and Ischemic Canine Kidney

Jaschke¹,

Lipton²,

Boyd³

et al. 1985

Acta Radiologica. Diagnosis

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The potential of CT scanning to explore total and regional renal blood flow was evaluated in a dog model with unilateral renal artery stenosis (n = 7, reduction of renal blood flow: 32-75% of base line flow). Attenuation versus time curves were generated for the renal cortex and medulla, as well as for the aorta and renal vein. A fast CT scanner was used which allowed for up to 24 scans/minute at the same level (slice thickness: 10 mm). A total of 10 ml contrast medium was injected into a peripheral vein for each scan series taken. During baseline conditions, the curve of the renal cortex and medulla demonstrated 2 peaks. The first peak was mainly related to early vascular enhancement, whereas the second peak corresponded mainly to the appearance of contrast medium in the distal convolutes and collecting ducts. Ischemia of the kidney resulted in a reduction of the first peak and a flattening of the leading edge slope. Transport of contrast medium through the extravascular compartments of the kidney was delayed during ischemia. Relative renal blood flow was obtained from the CT data by dividing peak enhancement by rise-time as assessed from the cortical curve. All measurements were related to baseline flow and validated by flow measurements using radioactive labeled microspheres (n = 5). Correlation was found to be r = 0.97.

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Measurement of Regional Changes in Myocardial Perfusion Using Dynamic Computed Tomography and Contrast Medium

Cited by 8 publications

References 8 publications

Measurement of myocardial blood flow by ultrafast computed tomography.

Measurement of myocardial blood flow by ultrafast computed tomography.

Computed axial tomography of the heart

Attenuation Changes of the Normal and Ischemic Canine Kidney

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