Development of a method to measure regional perfusion of the lung in anesthetized ponies using computed tomography angiography and the maximum slope model

OBJECTIVE To develop a method based on CT angiography and the maximum slope model (MSM) to measure regional lung perfusion in anesthetized ponies. ANIMALS 6 ponies. PROCEDURES Anesthetized ponies were positioned in dorsal recumbency in the CT gantry. Contrast was injected, and the lungs were imaged while ponies were breathing spontaneously and while they were mechanically ventilated. Two observers delineated regions of interest in aerated and atelectatic lung, and perfusion in those regions was calculated with the MSM. Measurements obtained with a computerized method were compared with manual measurements, and computerized measurements were compared with previously reported measurements obtained with microspheres. RESULTS Perfusion measurements obtained with the MSM were similar to previously reported values obtained with the microsphere method. While ponies were spontaneously breathing, mean +/- SD perfusion for aerated and atelectatic lung regions were 4.0 +/- 1.9 and 5.0 +/- 1.2 mL/min/g of lung tissue, respectively. During mechanical ventilation, values were 4.6 +/- 1.2 and 2.7 +/- 0.7 mL/min/g of lung tissue at end expiration and 4.1 +/- 0.5 and 2.7 +/- 0.6 mL/min/g of lung tissue at peak inspiration. Intraobserver agreement was acceptable, but interobserver agreement was lower. Computerized measurements compared well with manual measurements.