Simultaneous quantitative assessment of myocardial perfusion and function using analysis of color-encoded contrast-enhanced images

We hypothesized that analysis of color-encoded, contrast-enhanced, power modulation images could allow simultaneous quantification of myocardial perfusion and regional LV wall motion. We studied 12 anesthetized pigs at baseline, during acute ischemia and subsequent reperfusion, as well as 8 patients post acute myocardial infarction. Color kinesis was used to color-encode endocardial motion during real-time perfusion imaging with high-energy ultrasound pulses. Wall motion was assessed by calculating regional fractional area changes. Translation-free perfusion analysis was performed in automatically identified myocardial regions of interest. Steady-state intensity and initial rate of contrast replenishment were calculated. In all animals, ischemia caused reversible changes in the images and the calculated perfusion and function indices. A significant decrease in pixel intensity (14%) and contrast replenishment rate (66%) in LAD-related segments coincided with a decrease in fractional area change (34%). In patients, respective perfusion and function indices were 61%, 51% and 58% lower in segments where perfusion defects and/or regional wall motion abnormalities were noted in grey-scale images. Color-encoded, contrast-enhanced power modulation allows simultaneous real-time quantification of myocardial perfusion and regional LV function.