A Method for Quantitative Display of Three-Dimensional Regional Myocardial Function

The DSR (dynamic spatial reconstructor), a multiple X-ray source scanner that generates stop action three-dimensional (3-D) images of a cylindrical volume, was used for quantitative imaging of left ventricular 3-D wall geometry and function in experimentally induced canine left ventricular myocardial infarction. Impaired regional myocardial function was induced by myocardial ischemia or infarction in four mongrel dogs by closed-chest occlusion of the proximal left anterior descending (LAD) coronary artery. At intervals of 6-14 weeks post occlusion, the dogs were scanned with the DSR during biatrial contrast injection. The 3-D shape, extent, and function of hypokinetic myocardium was measured from the DSR images utilizing measurement of the rate of local systolic wall thickening to detect regions of normal, ischemic, or scarred myocardium. The results were compared to scar size and anatomic distribution measured at postmortem examination. The anatomic extent and relationship of hypocontractile to normally contracting muscle was visualized by computer generated, pseudo 3-D shaded surface displays of the left ventricular chamber and by topographic projections of regional wall thickening rates onto a map of the left ventricular endocardial surface. The location of myocardial infarction and the surrounding zone of impaired function is clearly defined by this 3-D CT scanning procedure. The display method presented here provides both localization and quantification of the volume of ischemic and infarcted myocardium.