Circulation, Vol 84, 1938-1956, Copyright © 1991 by American Heart Association
K Rosenfield, DW Losordo, K Ramaswamy, JO Pastore, RE Langevin, S Razvi, BD Kosowsky and JM Isner
BACKGROUND. Intravascular ultrasound provides high-resolution images of
vascular lumen, plaque, and subjacent structures in the vessel wall;
current instrumentation, however, limits the operator to viewing a single,
tomographic, two-dimensional image at any one time. Comparative analysis of
serial two-dimensional images requires repeated review of the video
playback recorded during the two-dimensional examination, followed by a
"mind's eye" type of imagined reconstruction. METHODS AND RESULTS.
Computer-based, automated three-dimensional reconstruction was used to
generate a tangible format with which to assess and compare a "stacked"
series of two-dimensional images. Three-dimensional representations were
prepared from sequential images obtained during intravascular ultrasound
examination in 52 patients, 50 of whom were studied before and/or after
percutaneous revascularization. Conventional two-dimensional ultrasound
images were acquired by means of a systematic, timed pullback of the
ultrasound catheter through the respective vascular segments. Images were
then assembled in automated fashion to create a three-dimensional depiction
of the vessel lumen and wall. Computer-enhanced three-dimensional
reconstructions were generated in both sagittal and cylindrical formats.
The sagittal format resulted in a longitudinal profile similar to that
obtained during angiographic examination; in contrast to angiography,
however, the sagittal reconstruction offered 360 degrees of limitless
orthogonal views of the plaque and arterial wall as well as the vascular
lumen. The cylindrical format yielded a composite view of a given vascular
segment, and a hemisected version of the cylindrical reconstruction enabled
en face inspection of the reconstructed luminal surface. Sagittal
reconstructions facilitated analysis of dissections and plaque fractures
resulting from percutaneous revascularization, and the hemisected
cylindrical reconstructions enhanced analysis of endovascular prostheses.
CONCLUSIONS. This preliminary experience demonstrates that computer-based
three-dimensional reconstruction may further augment the use of
intravascular ultrasound in assessing vascular pathology and guiding
interventional therapy.
ARTICLES
Three-dimensional reconstruction of human coronary and peripheral arteries from images recorded during two-dimensional intravascular ultrasound examination
Department of Medicine (Cardiology), St. Elizabeth's Hospital, Tufts University School of Medicine, Boston, MA 02135.
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