Circulation, Vol 75, 452-460, Copyright © 1987 by American Heart Association
GB Mancini, SB Simon, MJ McGillem, MT LeFree, HZ Friedman and RA Vogel
Quantitative coronary arteriography has been shown to be useful in
assessing the extent of coronary disease, its functional significance, and
its response to therapeutic interventions. Most current methods rely either
on hand-drawn arterial contours or automatic edge-detection algorithms
applied to 35 mm cineangiograms. To assess the performance in vivo of a
new, fully automatic, rapid coronary quantitation program, dogs were
instrumented with precision-drilled, plastic cylinders to create
intraluminal stenoses in the left anterior descending and/or circumflex
arteries, as well as with high-fidelity micromanometers and electromagnetic
flow probes. Stenosis diameters ranged from 0.83 to 1.83 mm. Biplane,
on-line, digital coronary angiograms and cineangiograms were recorded
during standard selective coronary arteriography in the closed-chest
preparation. The on-line digital images were analyzed in nonsubtracted and
subtracted modes. Cineangiograms were digitized to allow coronary
quantitation by the same computer program. There was an excellent
correlation between known and measured minimal diameter stenoses (r = .87
to .98, SEE = 0.09 to 0.24 mm). Interobserver and intraobserver variability
analysis showed high reproducibility (r = .90 to .97, SEE = 0.12 to 0.23
mm). The best results in both analyses were achieved by nonsubtracted
digital imaging and the worst by cineradiography. Measures of percent
diameter stenosis, percent area stenosis (geometric and videometric), and
absolute minimal cross-sectional area (geometric and videometric) were all
significantly correlated with independent measures of actual coronary flow
reserve. This study provides direct anatomic and physiologic validation in
vivo of a new and rapid coronary quantitation method suitable for analysis
of both digital angiograms and cineangiograms.
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Automated quantitative coronary arteriography: morphologic and physiologic validation in vivo of a rapid digital angiographic method [published erratum appears in Circulation 1987 Jun;75(6):1199]
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