Validation of an accurate method for three-dimensional reconstruction and quantitative assessment of volumes, lengths and diameters of coronary vascular branches and segments from biplane angiographic projections.

UNLABELLED

The goal of the study was the validation of an accurate method for three-dimensional reconstruction and quantitative assessment of volumes, lengths and diameters of coronary vascular branches and segments from biplane angiographic projections.

METHODS

The accuracy was tested in a complex phantom. In vivo, inter- and intraobserver agreement were assessed by analysis of routine angiograms. The sensitivity was evaluated using angiograms of patients having diagnostic vasoactive pharmacological intervention. Two-dimensional quantitative coronary angiography (2-D QCA) and 3-D QCA were compared concerning the accuracy of diameter evaluation.

RESULTS

3-D QCA yields accurate results (< 3% error) even based on nonorthogonal views, provided that projections parallel to the object are avoided. The inter- and intraobserver variability is < or = 5%. Significant (p < 0.01) changes of the volume (36-39%) and the diameter (19-21%) are detected following pharmacological intervention. 2-D QCA and 3-D QCA agree in short matched segments without foreshortening. 2-D QCA is rather sensitive to foreshortening and not suitable for evaluation of diameters of longer branches or total coronaries.

CONCLUSION

3-D QCA permits an accurate, reproducible and sensitive comprehensive three-dimensional geometric analysis of the coronaries and is superior to 2-D QCA with respect to extended diameter evaluation.