Quantitative tool for the assessment of myocardial perfusion during x-ray angiographic procedures

Abstract

During interventional procedures, cardiologists revascularize the ischemic heart by opening occluded arteries. Patency of the artery is assessed by selective injection of dye. Reperfusion of the myocardium is more difficult to estimate in the dim signal produced by the contrast agent in the microcirculation. Some researchers [1-2] have proposed and studied qualitative evaluations based on the observation of contrast appearance and wash-out in the heart muscle. In this paper, we describe a set of tools designed to assist the cardiologist in the assessment of myocardial perfusion. First, we apply synchronized subtraction in order to enhance the tissue opacification by removing the background. Secondly, to quantify the microcirculation temporal behavior, we compute time-density curves normalized with respect to the injection characteristics. Thirdly, we create parametric images that summarize in a single picture the dynamic information directly usable in the interventional setting. © 2009 Springer Berlin Heidelberg.