QUANTIFICATION OF VOLUMETRIC CORONARY BLOOD-FLOW WITH DUAL-ENERGY DIGITAL SUBTRACTION ANGIOGRAPHY

Background As a solution to the well-documented problems associated wi th visual interpretation of coronary arteriograms, more physiological methods of assessing coronary artery stenosis are being investigated. Volumetric coronary blood flow (BF) can be a valuable aid in the analy sis of functional significance of arterial obstruction. Methods and Re sults The left anterior descending coronary artery (LAD) of 15 anesthe tized pigs (40 to 50 kg) was dissected free from the epicardium in its proximal portion, and a transit-time ultrasound flow probe of the app ropriate size was applied. A vascular occluder was positioned distal t o the flow probe for flow adjustments. Contrast injections (2 to 4 mL/ s for 3 seconds) were made into the left main coronary artery during i mage acquisition with a motion-immune dual-energy digital subtraction angiography (DE DSA) system. Tissue-suppressed energy-subtracted image s were used to generate time-density curves. BF measurements were made in the LAD vascular bed with use of the time-density curve, with cons ideration that blood was momentarily replaced with contrast during the injection. In 19 comparisons, the mean BF, measured with the use of D E DSA, correlated extremely well with the mean ultrasound flow (DE DSA = 0.90 ultrasound + 3.10 mL/min, r = .96). Also, contrast injection i ncreased the BF by an average of only 15% during the image-acquisition time interval. Conclusions Accurate BF measurements can be made with motion-immune DE DSA. The BF measurements can be completed before the onset of significant changes in BF due to contrast injection. Furtherm ore, it is possible to make the BF measurements during routine coronar y arteriography.