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[冠心病诊断的新进展——三维融合图像]

[New developments in diagnosis of coronary heart disease--3D fusion image].

作者信息

Schindler T H, Magosaki N, Jeserich M, Krause T, Fischer R, Moser E, Nitzsche E, Just H, Solzbach U

机构信息

Medizinische Universitätsklinik Freiburg, Abteilung Innere Medizin III, Kardiologie und Angiologie.

出版信息

Z Kardiol. 2000 Apr;89(4):338-48. doi: 10.1007/s003920050494.

Abstract

The interpretation of three-dimensional (3D) structures of the coronary tree and the myocardium by a clinician demands a subjective visual integration of two-dimensional (2D) images of cardiac diagnostic procedures like coronary angiography and myocardial scintigraphy. Although in the conventional analysis of 2D display scintigraphic myocardial perfusion segments are arbitrarily assigned to three major coronary artery systems, the standard myocardial perfusion distribution territories correspond with the individual pathologic-anatomic coronary tree in only 50-60% of the patients. Hence, the mental integration of both 2D images of coronary angiography and myocardial scintigraphy does not necessarily allow an accurate assignment of particular myocardial perfusion regions to the corresponding vessels. For an objective assignment of each vessel segment of the coronary tree to the corresponding myocardial regions, we have developed a 3D "fusion image" technique and applied it to patients with coronary artery disease. Cause-and-effect relationships may be more obvious with 3D data fusion and may enable an easier comparison of anatomy and physiology. Preliminary results demonstrate that our newly developed 3D fusion image is useful for accurate assignment of coronary vessel segments to the corresponding myocardial perfusion regions and suggest that it may allow the clinician a comprehensive and accurate assessment of the patient's myocardial status.

摘要

临床医生对冠状动脉树和心肌的三维(3D)结构进行解读时,需要对冠状动脉造影和心肌闪烁显像等心脏诊断程序的二维(2D)图像进行主观的视觉整合。尽管在2D显示的传统分析中,闪烁显像心肌灌注节段被任意分配到三个主要冠状动脉系统,但标准的心肌灌注分布区域仅在50%-60%的患者中与个体病理解剖冠状动脉树相对应。因此,冠状动脉造影和心肌闪烁显像这两种2D图像的心理整合不一定能将特定的心肌灌注区域准确地分配到相应的血管。为了将冠状动脉树的每个血管节段客观地分配到相应的心肌区域,我们开发了一种3D“融合图像”技术,并将其应用于冠状动脉疾病患者。3D数据融合可能使因果关系更明显,并可能使解剖学和生理学的比较更容易。初步结果表明,我们新开发的3D融合图像可用于将冠状动脉血管节段准确分配到相应的心肌灌注区域,并表明它可能使临床医生能够全面、准确地评估患者的心肌状态。

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