Fractal analysis of the ischemic transition region in chronic ischemic heart disease using magnetic resonance imaging.
Objectives: To introduce a novel hypothesis and method to characterise pathomechanisms underlying myocardial ischemia in chronic ischemic heart disease by local fractal analysis (FA) of the ischemic myocardial transition region in perfusion imaging.Methods: Vascular mechanisms to compensate ischemia...
| Publicado en: | European Radiology Vol. 27; no. 4; pp. 1537 - 1547 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Apr2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121519119&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121519119 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Apr2017 vid: 27 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 121519119 121519119 144124121 NLM27436024 10.1007/s00330-016-4492-2 NLM27436024 121519119 ppf: 1537 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Fractal analysis of the ischemic transition region in chronic ischemic heart disease using magnetic resonance imaging. aug: au: Michallek, Florian Dewey, Marc affil: Charité - Universitätsmedizin Berlin, Institut für Radiologie , Charitéplatz 1 10117 Berlin Germany sug: subj: Myocardial Ischemia Magnetic Resonance Imaging Methods Image Processing, Computer Assisted Methods Female Chronic Disease Mathematics Aged Male Middle Age Reproducibility of Results Psychological Tests Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Objectives: To introduce a novel hypothesis and method to characterise pathomechanisms underlying myocardial ischemia in chronic ischemic heart disease by local fractal analysis (FA) of the ischemic myocardial transition region in perfusion imaging.Methods: Vascular mechanisms to compensate ischemia are regulated at various vascular scales with their superimposed perfusion pattern being hypothetically self-similar. Dedicated FA software ("FraktalWandler") has been developed. Fractal dimensions during first-pass (FDfirst-pass) and recirculation (FDrecirculation) are hypothesised to indicate the predominating pathomechanism and ischemic severity, respectively.Results: Twenty-six patients with evidence of myocardial ischemia in 108 ischemic myocardial segments on magnetic resonance imaging (MRI) were analysed. The 40th and 60th percentiles of FDfirst-pass were used for pathomechanical classification, assigning lesions with FDfirst-pass ≤ 2.335 to predominating coronary microvascular dysfunction (CMD) and ≥2.387 to predominating coronary artery disease (CAD). Optimal classification point in ROC analysis was FDfirst-pass = 2.358. FDrecirculation correlated moderately with per cent diameter stenosis in invasive coronary angiography in lesions classified CAD (r = 0.472, p = 0.001) but not CMD (r = 0.082, p = 0.600).Conclusions: The ischemic transition region may provide information on pathomechanical composition and severity of myocardial ischemia. FA of this region is feasible and may improve diagnosis compared to traditional noninvasive myocardial perfusion analysis.Key Points: • A novel hypothesis and method is introduced to pathophysiologically characterise myocardial ischemia. • The ischemic transition region appears a meaningful diagnostic target in perfusion imaging. • Fractal analysis may characterise pathomechanical composition and severity of myocardial ischemia. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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