Quantitative Coronary and Left Ventricular Cineangiography: Methodology and Clinical Applications

ISBN-13: 9789401083829 / Angielski / Miękka / 2011 / 470 str.

Johan H. C. Reiber;P.W. Serruys;C.J. Slager

Opis

In recent years there has been an increasing interest in quantitative analysis of coronary cineangiograms and already for a longer time of left ventricular cin- eangiograms. The needfor quantitationofcoronary arterialdimensions has been stimulated by the introduction ofnew therapeutic procedures in the catheteriza- tionlaboratory, suchas the balloon dilatationtechnique (PTCA) and thromboly- tic therapy, by the need to study the vasoactive responses of pharmaceutical agents, and also by the desire to study the progressive nature ofcoronary artery disease with the ultimate goal to find ways to bring a halt to the progression of coronary atherosclerosis or even achieve regression of the disease. Parallel with these clinical developments, rapid technical developments in computerarchitect- ures and semiconductor memories have made it possible to digitize and store cineframesor selected portions thereof in image processors and to analyze these pictorial data quantitatively at affordable prices. More than 15 years of research have been directed by various groups towards the semi- or fully-automated delineation of the left ventricular boundaries on a frame-to-frame basis. Yet not a single system with fully-automated capability is commercially available. In the mean time many different left ventricular wall motion models have been developed, again with little consensuson which model is to be preferred as no golden standard exists.

Spis treści

One - Methodology.- I. Left ventricular and Coronary Cineangiography; Overview of Techniques, Applications and Limitations.- Left ventricular cineangiography.- Cardiac volume.- Regional wall motion.- Wall motion models.- Left ventricular reference systems.- Left ventricular coordinate systems.- Validation studies various left ventricular wall motion models.- Coronary cineangiography.- Inter- and intraobserver variations in visual interpretation.- Number of projections.- Further limitations assessment lesion severity.- Physiological significance coronary obstruction.- Haemodynamics coronary obstruction.- ‘Critical lesion’.- Discrepancy relative obstruction measures and its functional significance.- Indirect approaches towards the assessment of the functional significance of obstructions.- Videodensitometry.- Pulsed Doppler coronary catheter.- Thallium-201 mycocardial imaging.- Positron-emission tomography.- Radionuclide washout techniques.- Digital radiography.- References.- II Cineangiocardiography.- Contrast agents.- The radiologic image.- The X-ray generator and tube.- X-ray absorption.- Image intensifier.- Optics and cinecamera.- Cinefilm exposure.- Cinefilm processing.- Film processing unit.- Video system.- Quality control.- Clinical factors in cineangiocardiography.- References.- III. Cardiovascular Angiography Analysis System (CAAS) 62.- Architecture Thoraxcenter CAAS.- Cine-video converter.- Calibration procedure.- Pincushion correction.- Contour detection of arterial segment.- Contour analysis.- Assessment severity of coronary obstruction.- Mean diameter arterial segment.- Hemodynamic parameters coronary obstruction.- Analysis time coronary cineangiogram.- Pie Data CAAS.- Cinefilm digitizer.- Data acquisition procedure.- References.- IV. Contouromat - A hard-wired left ventricular angio processing system.- General description.- Basic techniques.- Left ventricular data acquisition procedure (MAXI-cine).- Left ventricular data acquisition procedure (MINI-cine).- Automatically detected ED- and ES- contours.- Manual tracking ED- and ES- contours.- Left ventricular data analysis procedure (MAXI-cine).- Left ventricular data analysis procedure (MINI-cine).- Concluding remarks.- References.- V. Validation quantitation techniques of coronary and left ventricular cineangiograms.- A. Accuracy and precision contour detection technique.- B. Variability data analysis procedure.- C. Overall variabilities of repeated coronary cineangiography and computer analysis.- Statistical analysis.- Short-term (5 min.) variability.- Medium-term (1 hour) variability.- Long-term (90 days) variability.- D. Discussion evaluation data CAAS.- Technical characteristics.- Sources of error in angiographic and analysis procedures.- Variabilities of acquisition and analysis procedures.- E. Performance evaluation Contouromat.- Average processing time per cineframe.- Percentage of cineframes requiring one or more manual corrections.- Average number of corrections per corrected cineframe and volume effects of corrections.- F. Discussion evaluation data Contouromat.- References.- VI. Assessment of dimensions and image quality of coronary contrast catheters from cineangiograms.- Summary.- Methods.- Materials.- Results.- Discussion.- References.- VII. Densitometric analysis coronary cineangiograms.- The X-ray-Cine-Video imaging system.- Transfer functions of the different system components.- X-ray beam attenuation.- Image intensifier.- Cinefilm exposure.- Film digitizer.- Analog-to-digital conversion.- Relationship between measured brightness level and object attenuation factor.- Practical applications.- Densitometry from contrast image.- Gated subtraction method.- Evaluation study.- Concluding remarks.- References.- VIII. 3-D reconstruction of coronary arterial segments from two projections.- Problem analysis and overview of pertinent literature.- Basic principles.- Cost coefficient matrix.- Noise considerations.- Registration of the two orthogonal projections.- Clinical example.- Preliminary evaluation 3-D reconstruction algorithms.- References.- IX. Structural analysis of the coronary and retinal arterial trees 185.- Overview of other approaches.- Methodology.- Preprocessing.- Segmentation in first frame.- Frame-to-frame segmentation.- Model/data synchronization.- Three-dimensional epicardial motion.- Applications.- Analysis of retinal fluorescein angiograms.- The RFT cinerecording of retinal flow.- Detection of the retinal arterial vessel patterns.- Measurement flow velocities in retinal vessels.- Concluding remarks analysis retinal images.- References.- X. A methodological review of quantification systems for coronary and left ventricular cineangiograms.- Quantitative coronary cineangiography.- Cinefilm conversion.- Contour detection coronary arterial segment.- Definition global centerline.- Edge enhancement.- Contour definition.- Pincushion correction.- Calibration.- Contour analysis.- Densitometry.- Three-dimensional reconstruction.- Concluding remarks.- Quantitative left ventricular cineangiography.- Light-pen computer processing.- Off-line processing of left ventricular cineangiograms.- On-line processing of left ventricular angiograms.- Analog video processing.- Digital image processing.- Concluding remarks.- References.- XI Quantitative assessment of regional left ventricular function: Endocardial landmark motion.- Summary.- Materials and methods.- Results.- Endocardial wall motion in pigs.- Endocardial wall motion in humans.- Discussion.- References.- XII. The cardiovascular database and the coronary reporting system.- CAAS database.- Coronary reporting system.- Summary.- References.- Two - Clinical Applications.- XIII. Influence of intracoronary nifedipine on left ventricular function, coronary vasomotility, and myocardial oxygen consumption 275.- Summary.- Patients and methods.- Patients and design of the study.- Analysis of isovolumic indices during ventriculography.- Analysis of global and regional left ventricular function during systole and diastole.- Coronary sinus blood flow measurement and myocardial oxygen consumption.- Quantitative coronary angiography.- Results.- Global systolic and diastolic left ventricular function.- Regional left ventricular function.- Coronary sinus blood flow and myocardial oxygen consumption.- Quantitative coronary cineangiography.- Discussion.- Global and regional left ventricular function.- Coronary blood flow and myocardial oxygen consumption.- Quantitative coronary angiography.- Conclusion.- References.- XIV. Effect of intracoronary thrombolytic therapy on global and regional left ventricular function. A three years experience with randomization.- Summary.- Patient selection and methods.- Patient selection.- Study protocol.- Analysis of global and regional LV function.- Statistical analysis.- Results.- Discussion.- References.- XV. Effect of coronary occlusion during percutaneous transluminal angioplasty in man on left ventricular chamber stiffness and regional diastolic pressure-radius relations.- Summary.- Patients and methods.- Patients.- Study protocol.- Data analysis.- Calculations.- Statistical analysis.- Results.- Discussion.- References.- XVI. Is transluminal coronary angioplasty mandatory after successful thrombolysis? A quantitative coronary angiographic study 326.- Summary.- Patients and methods.- Technique of intracoronary streptolysis.- Technique of percutaneous transluminal coronary angioplasty.- Quantitative angiographic analysis.- Results.- Patency of the infarct related vessel, acute and chronic stage.- Quantitative angiographic analysis.- Discussion.- References.- XVII. Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: diameter versus densitometric area measurements.- Summary.- Methods.- Quantitative analysis of coronary obstructions.- Study population.- Results.- Discussion.- References.- XVIII. Left ventricular performance, regional blood flow, wall motion and lactate metabolism during transluminal angioplasty.- Summary.- Materials and methods.- Study population and protocol.- Analysis of pressure-derived indices during systole and diastole.- Determination of relaxation parameters.- Semilogarithmic model.- Exponential model.- Derivative model.- Analysis of global and regional left ventricular function during systole and diastole.- Results.- Analysis of pressure-derived indices during systole and diastole.- Global left ventricular function during systole and diastole.- Regional left ventricular function.- Coronary blood flow and lactate metabolism.- Discussion.- Global and regional left ventricular performance.- Coronary hemodynamics.- Metabolic disturbances.- Clinical implications.- References.- XIX. The role of vascular wall thickening during changes in coronary artery tone.- Summary.- Methods.- Patients selection and test procedure.- Quantitative angiographic analysis.- Geometric considerations: dynamic vascular wall thickening.- Results.- Discussion.- References.- XX. Responses of normal and obstructed coronary arterial segments to cold stimulation; a quantitative angiographic study.- Summary.- Methods.- Study population.- Coronary angiography and cold stimulation.- Quantitative angiographic analysis.- Statistical analysis.- Results.- Changes in arterial dimensions in non-obstructed segments induced by CPT.- Diameter changes by CPT in different non-obstructed segments.- Responses of stenotic segments and lesions to CPT.- Discussion.- References.- XXI Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and exercise thallium scintigraphy.- Summary.- Methods.- Patients selection.- Quantitative coronary angiography.- Noninvasive testing.- Statistical analysis.- Results.- Discussion.- References.- XXII. Quantitative coronary angiography in a lipid intervention study (The Leiden Diet Intervention Trial).- Summary.- Methods.- Patients.- Diet.- Biochemical measurements.- Quantitative coronary arteriography.- Coronary angiographic scoring method.- Statistical analysis.- Results.- Discussion.- References.- XXIII. Asynchrony in regional filling dynamics as a consequence of uncoordinated segmental contraction during coronary transluminal occlusion.- Summary.- Materials and methods.- Study population.- Study protocol.- Analysis of pressure and pressure-derived indices.- Analysis of regional and global left ventricular function.- Statistical analysis.- Results.- Global indices of left ventricular ejection and filling.- Regional indices of left ventricular ejection and filling.- Discussion.- Methodological considerations.- Determinants of filling dynamics.- Role of asynchronous contraction.- References.- Index of subjects.