Abstract
Background Conventional quantitative assessment of myocardial perfusion analyzes the temporal relation between the arterial input function and the myocardial signal intensity curves, thereby neglecting many of the spatial and temporal relations within the myocardial signal intensity curves. These relations can be described by calculating the perfusion gradient between the left ventricular (LV) epicardial endocardial layers and expressing indexes such as the persistence (seconds), and strength (mean gradient / circumferential extent) of the gradient. As myocardial ischaemia predominantly affects the endocardial myocardial layer due to its higher oxygen demand, transmural gradient indexes may be sensitive markers of ischaemia.
Highlights
Conventional quantitative assessment of myocardial perfusion analyzes the temporal relation between the arterial input function and the myocardial signal intensity curves, thereby neglecting many of the spatial and temporal relations within the myocardial signal intensity curves
At a threshold of 5%, the transmural perfusion gradient analysis yielded a sensitivity of 94% and a specificity of 42% for the detection of significant coronary stenosis on a per-vessel basis
Additional analysis combining the persistence or the strength of the gradient with a 5% threshold resulted in significant differences between
Summary
Conventional quantitative assessment of myocardial perfusion analyzes the temporal relation between the arterial input function and the myocardial signal intensity curves, thereby neglecting many of the spatial and temporal relations within the myocardial signal intensity curves. These relations can be described by calculating the perfusion gradient between the left ventricular (LV) epicardial endocardial layers and expressing indexes such as the persistence (seconds), and strength (mean gradient / circumferential extent) of the gradient. As myocardial ischaemia predominantly affects the endocardial myocardial layer due to its higher oxygen demand, transmural gradient indexes may be sensitive markers of ischaemia
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