Int J Comput Assist Radiol Surg - Fusion of coronary angiography and stress echocardiography for myocardial viability evaluation.

Tópicos

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Resumo

RPOSE: Identification of viable myocardial tissue is important for patients with a low left ventricular ejection fraction, since revascularization is effective only if the affected region is viable. After cineangiographic identification of occluded coronary vessels, the myocardial viability is usually determined using cardiac MRI or SPECT. Alternatively, myocardial deformation imaging by echocardiography has been introduced that allows detection of viable myocardium directly within the catheterization laboratory. Multimodality fusion of coronary angiograms and echocardiograms was developed to match viable regions with areas affected by occluded vessels.METHODS: Identification of corresponding myocardial regions in both coronary angiograms and ultrasound scans was performed using multimodality image fusion. Geometrically correct superposition of these images was done to allow direct identification of the involved myocardial regions. An electromagnetic tracking system was used as a common base for co-registration of the images. The system was tested using a phantom test device in a cardiac catheterization laboratory.RESULTS: A 2D projection error of 3.8?1.1 mm was achieved in trials using a cardiac phantom test object.CONCLUSIONS: Superimposition of the occluded coronary artery and the regional myocardial viability was achieved using automated multimodality fusion of coronary angiograms and stress echocardiograms with in vitro experiments. This system is promising for integrated single step angiography and angioplasty that may reduce procedure time, cost and length of hospitalization. Further testing in vivo is needed to verify and validate the system in a clinical setting.

Resumo Limpo

rpose identif viabl myocardi tissu import patient low left ventricular eject fraction sinc revascular effect affect region viabl cineangiograph identif occlud coronari vessel myocardi viabil usual determin use cardiac mri spect altern myocardi deform imag echocardiographi introduc allow detect viabl myocardium direct within catheter laboratori multimod fusion coronari angiogram echocardiogram develop match viabl region area affect occlud vesselsmethod identif correspond myocardi region coronari angiogram ultrasound scan perform use multimod imag fusion geometr correct superposit imag done allow direct identif involv myocardi region electromagnet track system use common base coregistr imag system test use phantom test devic cardiac catheter laboratoryresult d project error mm achiev trial use cardiac phantom test objectconclus superimposit occlud coronari arteri region myocardi viabil achiev use autom multimod fusion coronari angiogram stress echocardiogram vitro experi system promis integr singl step angiographi angioplasti may reduc procedur time cost length hospit test vivo need verifi valid system clinic set

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