(Circulation. 1997;96:2944-2952.)
© 1997 American Heart Association, Inc.
Articles |
ECG-Gated Three-dimensional Intravascular Ultrasound
Feasibility and Reproducibility of the Automated Analysis of Coronary Lumen and Atherosclerotic Plaque Dimensions in Humans
From the Thoraxcenter, Division of Cardiology, University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam (C. von B., E. de V., A.N., N.B., W.L., C.J.S., J.R.T.C.R., P.W.S., P.J. de F.), and the Interuniversity Cardiology Institute (W.L., P.W.S.), Netherlands; and the Washington (DC) Hospital Center (G.S.M.). Dr von Birgelen is now at the Department of Cardiology, University Hospital Essen, Germany.
Correspondence to Pim J. de Feyter, MD, PhD, Thoraxcenter, Bd 381, PO Box 1738, 3000 DR Rotterdam, Netherlands.
Background Automated systems for the quantitative analysis of three-dimensional (3D) sets of intravascular ultrasound (IVUS) images have been developed to reduce the time required to perform volumetric analyses; however, 3D image reconstruction by these nongated systems is frequently hampered by cyclic artifacts.
Methods and Results We used an ECG-gated 3D IVUS image acquisition workstation and a dedicated pullback device in atherosclerotic coronary segments of 30 patients to evaluate (1) the feasibility of this approach of image acquisition, (2) the reproducibility of an automated contour detection algorithm in measuring lumen, external elastic membrane, and plaque+media cross-sectional areas (CSAs) and volumes and the cross-sectional and volumetric plaque+media burden, and (3) the agreement between the automated area measurements and the results of manual tracing. The gated image acquisition took 3.9±1.5 minutes. The length of the segments analyzed was 9.6 to 40.0 mm, with 2.3±1.5 side branches per segment. The minimum lumen CSA measured 6.4±1.7 mm2, and the maximum and average CSA plaque+media burden measured 60.5±10.2% and 46.5±9.9%, respectively. The automated contour-detection required 34.3±7.3 minutes per segment. The differences between these measurements and manual tracing did not exceed 1.6% (SD<6.8%). Intraobserver and interobserver differences in area measurements (n=3421; r=.97 to.99) were <1.6% (SD<7.2%); intraobserver and interobserver differences in volumetric measurements (n=30; r=.99) were <0.4% (SD<3.2%).
Conclusions ECG-gated acquisition of 3D IVUS image sets is feasible and permits the application of automated contour detection to provide reproducible measurements of the lumen and atherosclerotic plaque CSA and volume in a relatively short analysis time.
Key Words: ultrasonics • coronary disease • imaging
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