Progress in Digital Angiocardiography

346 Pages·1988·8.837 MB·English

by  E. Zeitler, W. Seyferth (auth.), Paul H. Heintzen M.D., Joachim H. Bürsch M.D. (eds.)

PROGRESS IN DIGITAL ANGIOCARDIOGRAPHY
DEVELOPMENTS IN
CARDIOVASCULAR MEDICINE
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Heintzen PH, Bursch JH, eds: Progress in digital angiocardiography. 1988. ISBN 0-89838-965-8.
PROGRESS IN DIGITAL
ANGIOCARDIOGRAPHY
edited by
P.H. HEINTZEN and 1.H. BURSCH
Department of Pediatric Cardiology and Biomedical Engineering,
Kiel University, F.R.C.
1988 KLUWER ACADEMIC PUBLISHERS
DORDRECHT I BOSTON I LONDON
Distributors
for the United States and Canada: Kluwer Academic Publishers, 101 Philip Drive,
Norwell, MA 02061, USA
for all other countries: Kluwer Academic Publishers Group, P.O. Box 322,
3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Progress in digital angiocardiography.
(Developments in cardiovascular medicine)
Includes index
1. Angiocardiography--Digital techniques.
I. Heintzen, Paul H. II. BUrsch, J. H. III. Series.
[DNLM: 1. Angiocardiography--trends. 2. Coronary
Disease--radiography. 3. Radiographic Image Enhancement.
4. Subtraction Technic. HI DE997VME / WG 300 P9645j
RC683.5.A5P76 1987 616.1'20757 87-20270
ISBN-13: 978-94-010-7093-5 e-ISBN-13: 978-94-009-1331-8
DOl: 10.1007/978-94-009-1331-8
Copyright
© 1988 by Kluwer Academic Publishers, Dordrecht.
Softcover reprint of the hardcover 1s t edition
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the copyright owners.
Table of Contents
Preface IX
List of major contributors XI
PART I: DIGITAL ANGIOCARDIOGRAPHY FOR
DIAGNOSTIC ROUTINE
1. Results with digital angiography 3
E. Zeitler & W Seyferth
2. Digital angiography in coronary heart disease 13
K. Bachmann & R. Gansser
3. Digital coronary arteriography in the outpatient clinic 25
H. Abe & K. Himi
4. Digital subtraction angiography, the new standard in pediatric
cardiology? 33
H. L. Chernoff
PART II: DIGITAL VENTRICULOGRAPHY
i. QUANTITATION OF VALVULAR INSUFFICIENCY
5. Quantitation of valvular regurgitation by digital ventricular angio-
cardiography 39
J.H. Bursch, J. Zerbst & P.H. Heintzen
6. Quantification of aortic regurgitation 51
P. -A. Doriot, J. Divernois, P. Chatelain & W Rutishauser
7. Quantitative assessment of aortic regurgitation by digital sub-
traction angiography 63
P.A. Grayburn & S.E. Nissen
VI
ii. ASSESSMENT OF CARDIAC DYNAMICS
8. Quantitation of ventricular dynamic geometry by digital angiocar-
diography 71
P.E. Lange, W. Budach, B. Ewert, D.G. W. Onnasch &
P.H. Heintzen
9. Accuracy of digital subtraction angiocardiography for the assess
ment of global and regional left ventricular function at rest and
during exercise 87
O.M. Hess, D. Grob, I. Grimm, B. Birchler, P. Niederer &
H. P. Krayenbiihl
10. Assessment of synchronism of left ventricular wall motion 99
P.-A. Doriot, I.P. Melchior, P. Chatelain & W. Rutishauser
11. Assessment of left ventricular pressure-volume relationships
using an automatic computerized video densitometric approach 107
R. Simon, I. Kopp, I. Amende, W. Quante & P.R. Lichtlen
12. Computed triple orthogonal projections for optimal radiological
imaging with biplane isocentric multidirectional X-ray systems 119
H. Wollschlager, A.M. Zeiher, P. Lee, U. Solzbach,
T. Bonzel & H. lust
13. Clinical applications of cine computed tomography 127
M.L. Marcus, I.A. Rumberger, S.J. Reiter, W. Stanford,
C.A. Stark & A.J. Feiring
PART III: DIGITAL CORONARY ANGIOGRAPHY
i. ASSESSMENT OF CORONARY MORPHOLOGY
14. Morphologic and densitometric analysis of coronary arteries 137
1.H. C. Reiber
15. Comparison of 35 mm cine film and digital radiographic image
imaging for quantitative coronary arteriography 159
R.A. Vogel, M. T. LeFree & G.B.!. Mancini
16. Nonlinearity by densitometric measurements of coronary arteries 173
P.-A. Doriot, Y. Pochon, R. Welz & W. Rutishauser
17. Three-dimensional reconstruction and cross-section measure
ments of coronary arteries using ECG-correlated digital coronary
arteriography 181
D.L. Parker, D.L. Pope, R.E. van Bree & H. Marshall
18. Fast automatic recognition and 3D reconstruction of the coronary
tree from DSA-projection pairs 193
K. Barth, R. Koch & P. Marhoff
VII
ii. ASSESSMENT OF CORONARY FLOW AND
MYOCARDIAL PERFUSION
19. Concepts for coronary flow and myocardial perfusion measure
ments 201
1.H. Bursch & P.H. Heintzen
20. Blood flow measurements in digital cardiac angiography using 3D
coronary artery reconstructions 215
D.L. Parker, D.L. Pope, R.E. van Bree & H. Marshall
21. Coronary blood flow and myocardial perfusion studied by dig-
itized coronary angiograms 221
W Rutishauser, O. Ratib, F. Chappuis, P.-A. Doriot &
B. Meier
22. Comparison of time parameters derived from myocardial time
density curves in patients before and after percutaneous trans-
luminal coronary angioplasty 227
T. van der Werf, R.M. Heethaar, H. Stegehuis, N.H.l. Pijls &
F.L. Meijler
23. Methods for calculation of coronary flow reserve by computer
processing of digital angiograms 237
S.E. Nissen, 1.L. Elion & A.N. DeMaria
24. Parametric encoding of coronary arteriograms for the evaluation
of hyperemic reserve 253
1.L. Elion & S.E. Nissen
25. Digital angiographic transfer function analysis of regional myo
cardial perfusion: measurement system and coronary contrast
transit linearity 265
N.L. Eigler, I.M. Pfaff, I.S. Whiting, A. Zeiher,
I.S. Forrester & H.J.C Swan
iii. ASSESSMENT OF CORONARY STENOSIS AND ITS
FUNCTIONAL SIGNIFICANCE
26. Relation between coronary flow reserve and severity of coronary
obstruction, both assessed from coronary cineangiogram 275
1.H.C Reiber, F. Zijlstra,l. van Ommeren & P. W Serruys
27. Coronary arteriography, stress test and coronary flow reserve
measurements: comparative studies 293
G.B.l. Mancini & R.A. Vogel
28. Functional and anatomic assessment of coronary artery stenoses 305
K.L. Gould
VIn
PART IV: TECHNICAL CONSIDERATIONS ON
DIGITAL SYSTEMS
29. Reconstruction of the spatial distribution of the myocardial perfu-
sion from multiple-view arteriography 327
D.G. W. Onnasch, J. Lindenau, J.B. Bursch &
P.B. Heintzen
30. A bottleneck model of imaging systems for digital angiocardiog-
raphy 337
R. Brennecke
Index of subjects 351
Preface
According to Schopenhauer problems are usually passing through three
stages:
- in the first stage they are ignored or just smiled at,
- in the second stage they are fought, and
in the third stage they are considered to be self-evident, just taken for
granted.
Whereas digital subtraction angiography (DSA) has obviously reached stage
three of that scale, i.e. routine use in radiology, digital angiocardiography, in
particular imaging the heart and coronary circulation, is still on its way to the
final goal: the filmless heart catheterization laboratory for all invasive and
interventional procedures.
A few pioneers have already completely abandoned the conventional cine
coronary and angiocardiographic technique, others - as we do - still combine
both digital and conventional methods in clinical routine, but most cardiol
ogists up till now stay sceptically aside.
We hope that at least some of the articles published in this volume may
convince more and more cardiologists that digital imaging procedures are the
method of choice, in particular if quantitative assessment of the anatomical or
functional status of the cardiovascular system is required (pre- and post
operations or pre- and post-interventions).
Such a critical control of all therapeutic procedures, be it by surgical,
catheter- or medical 'interventions', is indeed an urgent and widely under
estimated or neglected requirement.
In this context digital electronic angiocardiographic imaging of the beating
heart might even be more important for straightforward quantifying cardiac
dynamics, valvular regurgitation, the coronary circulation, in particular coro
nary flow reserve, and myocardial perfusion, than just imaging the malformed
heart or coronary arteries. Examples of the potential of digital angiocardio
graphy with or without subtraction and digital functional angiocardiography
are given in this volume.
x
Although the saying by Shakespeare that dreams are the stuff that progress is
made of might be true, it is our experience that one needs much hard work
and some luck to convert such dreams into reality! This is certainly true for the
dream of an all-digital catheterization and cardiovascular imaging laboratory
acceptable to almost all cardiologists.
The need is obvious, the technology is available and the roentgen-industry is
capable and willing to cooperate, if we give them the 'right' message. Even if
progress might be slow, it will be - as predicted - irresistible. We hope that
these proceedings of the fourth Kiel conference will help to speed up this
progress.
The editors are grateful to all those who have helped in many different ways
to make this meeting and publication possible, in particular Dr. Onnasch and
the staff of our department. We are again greatly indebted to Pharma Schwarz
and in particular to Mr. Giicker, who - without any direct relationship to this
field - sponsored the meeting in the usual generous way. Finally, Mr. Com
mandeur and Kluwer Academic Publishers deserve special acknowledgement
for the pleasant cooperation.
Kiel, January 1988 Paul H. Heintzen
Joachim H. Biirsch