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Automated quantification of microvascular perfusion.

ABSTRACT: OBJECTIVE:Changes in microvascular perfusion have been reported in many diseases, yet the functional significance of altered perfusion is often difficult to determine. This is partly because commonly used techniques for perfusion measurement often rely on either indirect or by-hand approaches. METHODS:We developed and validated a fully automated software technique to measure microvascular perfusion in videos acquired by fluorescence microscopy in the mouse gastrocnemius. Acute perfusion responses were recorded following intravenous injections with phenylephrine, SNP, or saline. RESULTS:Software-measured capillary flow velocity closely correlated with by-hand measured flow velocity (R2 = 0.91, P < 0.0001). Software estimates of capillary hematocrit also generally agreed with by-hand measurements (R2 = 0.64, P < 0.0001). Detection limits range from 0 to 2000 ?m/s, as compared to an average flow velocity of 326 ± 102 ?m/s (mean ± SD) at rest. SNP injection transiently increased capillary flow velocity and hematocrit and made capillary perfusion more steady and homogenous. Phenylephrine injection had the opposite effect in all metrics. Saline injection transiently decreased capillary flow velocity and hematocrit without influencing flow distribution or stability. All perfusion metrics were temporally stable without intervention. CONCLUSIONS:These results demonstrate a novel and sensitive technique for reproducible, user-independent quantification of microvascular perfusion.

SUBMITTER: McClatchey PM

PROVIDER: S-EPMC6401325 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Automated quantification of microvascular perfusion.

McClatchey Penn Mason PM Mignemi Nicholas A NA Xu Zhengang Z Williams Ian M IM Reusch Jane E B JEB McGuinness Owen P OP Wasserman David H DH

Microcirculation (New York, N.Y. : 1994) 20180715 6

<h4>Objective</h4>Changes in microvascular perfusion have been reported in many diseases, yet the functional significance of altered perfusion is often difficult to determine. This is partly because commonly used techniques for perfusion measurement often rely on either indirect or by-hand approaches.<h4>Methods</h4>We developed and validated a fully automated software technique to measure microvascular perfusion in videos acquired by fluorescence microscopy in the mouse gastrocnemius. Acute per ...[more]

PMID: 29908041

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Project description:ObjectivesThis study sought to assess the performance of cardiovascular magnetic resonance (CMR) myocardial perfusion mapping against invasive coronary physiology reference standards for detecting coronary artery disease (CAD, defined by fractional flow reserve [FFR] ≤0.80), microvascular dysfunction (MVD) (defined by index of microcirculatory resistance [IMR] ≥25) and the ability to differentiate between the two.BackgroundDifferentiation of epicardial (CAD) and MVD in patients with stable angina remains challenging. Automated in-line CMR perfusion mapping enables quantification of myocardial blood flow (MBF) to be performed rapidly within a clinical workflow.MethodsFifty patients with stable angina and 15 healthy volunteers underwent adenosine stress CMR at 1.5T with quantification of MBF and myocardial perfusion reserve (MPR). FFR and IMR were measured in 101 coronary arteries during subsequent angiography.ResultsTwenty-seven patients had obstructive CAD and 23 had nonobstructed arteries (7 normal IMR, 16 abnormal IMR). FFR positive (epicardial stenosis) areas had significantly lower stress MBF (1.47 ± 0.48 ml/g/min) and MPR (1.75 ± 0.60) than FFR-negative IMR-positive (MVD) areas (stress MBF: 2.10 ± 0.35 ml/g/min; MPR: 2.41 ± 0.79) and normal areas (stress MBF: 2.47 ± 0.50 ml/g/min; MPR: 2.94 ± 0.81). Stress MBF ≤1.94 ml/g/min accurately detected obstructive CAD on a regional basis (area under the curve: 0.90; p < 0.001). In patients without regional perfusion defects, global stress MBF <1.82 ml/g/min accurately discriminated between obstructive 3-vessel disease and MVD (area under the curve: 0.94; p < 0.001).ConclusionsThis novel automated pixel-wise perfusion mapping technique can be used to detect physiologically significant CAD defined by FFR, MVD defined by IMR, and to differentiate MVD from multivessel coronary disease. A CMR-based diagnostic algorithm using perfusion mapping for detection of epicardial disease and MVD warrants further clinical validation.

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Automated quantification of microvascular perfusion.

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Automated quantification of microvascular perfusion.

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