Copyright © 2005, The European Society of Cardiology
Quantitative diagnosis of stress-induced myocardial ischemia using analysis of contrast echocardiographic parametric perfusion images*
Noninvasive Cardiac Imaging Laboratory, Department of Medicine, Section of Cardiology, University of Chicago, MC5084, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
Received 9 May 2005; received in revised form 12 July 2005; accepted after revision 28 July 2005.
rlang{at}medicine.bsd.uchicago.edu
* Corresponding author. Tel.: +1 773 702 1842; fax: +1 773 702 1034. vmoravi{at}medicine.bsd.uchicago.edu
 |
Abstract |
|---|
Aims Parametric imaging of myocardial perfusion provides useful visual information for the diagnosis of coronary artery disease (CAD). We developed a technique for automated detection of perfusion defects based on quantitative analysis of parametric perfusion images and validated it against coronary angiography.
Methods and results Contrast-enhanced, apical 2-, 3- and 4-chamber images were obtained at rest and with dipyridamole in 34 patients with suspected CAD. Images were analyzed to generate parametric perfusion images of the standard contrast-replenishment model parameters A, β and A·β. Each parametric image was divided into six segments, and mean parameter value (MPV) was calculated for each segment. Segmental MPV ratio between stress and rest was defined as a flow reserve index (FRI). Receiver operating characteristics (ROC) analysis was used in a Study group (N=17) to optimize FRI threshold and the minimal number of abnormal segments per vascular territory (LAD and non-LAD), required for automated detection of stress-induced perfusion defects. The optimized detection algorithm was then tested prospectively in the remaining 17 patients (Test group). LAD and non-LAD stenosis >70% was found in 19 and 17 patients, respectively. In the Study group, FRI threshold was: LAD=0.95 and non-LAD=0.68, minimal number of abnormal segments was four and two, correspondingly. Sensitivity, specificity and accuracy in the Test group were: 75%, 67% and 71% in the LAD, and 75%, 75% and 75% in the non-LAD territories.
Conclusion Automated quantitative analysis of contrast echocardiographic parametric perfusion images is feasible and may aid in the objective detection of CAD.
Keywords: Ultrasound imaging; Contrast media; Myocardial blood flow
* This work has been supported by research grant from Bristol–Myers Squibb and a Grant-in-Aid from the American Heart Association (VMA).
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in Eur J Echocardiogr:
- Myocardial contrast quantitation during stress echocardiography
- Abdou Elhendy and Thomas R. Porter
Eur J Echocardiogr 2006 7: 185-186.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  S. S. Abdelmoneim, A. Dhoble, M. Bernier, P. J. Erwin, G. Korosoglou, R. Senior, S. Moir, I. Kowatsch, S. Xian-Hong, T. Muro, et al. Quantitative myocardial contrast echocardiography during pharmacological stress for diagnosis of coronary artery disease: a systematic review and meta-analysis of diagnostic accuracy studies Eur J Echocardiogr, October 1, 2009; 10(7): 813 - 825. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Lonnebakken, E. M. Staal, O. Bleie, E. Strand, O. K. Nygard, and E. Gerdts Quantitative contrast stress echocardiography in assessment of restenosis after percutaneous coronary intervention in stable coronary artery disease Eur J Echocardiogr, October 1, 2009; 10(7): 858 - 864. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Vogel, A Indermuhle, P Meier, and C Seiler Quantitative stress echocardiography in coronary artery disease using contrast-based myocardial blood flow measurements: prospective comparison with coronary angiography Heart, March 1, 2009; 95(5): 377 - 384. [Abstract] [Full Text] [PDF]
|
|