Vessel masking improves densitometric myocardial perfusion assessment

Int J Cardiovasc Imaging. 2009 Mar;25(3):229-36. doi: 10.1007/s10554-008-9374-5. Epub 2008 Oct 4.

Abstract

Introduction: The objective of treatment in acute myocardial infarction (AMI) is reperfusion of the myocardium at risk. Our goal was to evaluate the effect of vessel masking on videodensitometric assessment of myocardial reperfusion.

Methods: Epicardial vessels were masked out from the densitometric region of interest, where average rise slope (G(max)/T(max)) of time-density curves (TDC) were measured. Measurements were tested to detect indicators of reperfusion as cumulative creatine-kinase (CK) release and ST-resolution by receiver operating characteristic (ROC) curve analysis.

Results: When vessel masking was applied before G(max)/T(max) measurement, an improvement has been observed in sensitivity and area under ROC curve to detect indicators of reperfusion as cumulative enzyme release (sensitivity (Se): 85% vs. 61%, area under the curve (AUC): 0.84 vs. 0.76) and ST-resolution (Se: 74% vs. 67%, AUC: 0.83 vs. 0.79).

Conclusions: Selective myocardial perfusion measurement on coronary angiograms is feasible and serves as an informative method to detect myocardial viability after AMI and revascularization therapy. The present study demonstrated that vessel masking improves results compared to simple densitometric analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiography, Digital Subtraction
  • Angioplasty, Balloon, Coronary
  • Contrast Media
  • Coronary Angiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging*
  • Myocardial Infarction / therapy*
  • Myocardial Reperfusion / methods*
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Sensitivity and Specificity

Substances

  • Contrast Media