Philips Research North America, Briarcliff Manor, NY, USA.
Circ Cardiovasc Interv. 2010 Feb 1;3(1):71-9. doi: 10.1161/CIRCINTERVENTIONS.109.897629. Epub 2010 Jan 26.
Although fixed view x-ray angiography remains the primary technique for anatomic imaging of coronary artery disease, the known shortcomings of 2D projection imaging may limit accurate 3D vessel and lesion definition and characterization. A recently developed method to create 3D images of the coronary arteries uses x-ray projection images acquired during a 180 degrees C-arm rotation and continuous contrast injection followed by ECG-gated iterative reconstruction. This method shows promise for providing high-quality 3D reconstructions of the coronary arteries with no user interaction but requires clinical evaluation.
The reconstruction strategy was evaluated by comparing the reconstructed 3D volumetric images with the 2D angiographic projection images from the same 23 patients to ascertain overall image quality, lesion visibility, and a comparison of 3D quantitative coronary analysis with 2D quantitative coronary analysis. The majority of the resulting 3D volume images were rated as having high image quality (66%) and provided the physician with additional clinical information such as complete visualization of bifurcations and unobtainable views of the coronary tree. True-positive lesion detection rates were high (90 to 100%), whereas false-positive detection rates were low (0 to 8.1%). Finally, 3D quantitative coronary analysis showed significant similarity with 2D quantitative coronary analysis in terms of lumen diameters and provided vessel segment length free from the errors of foreshortening.
Fully automated reconstruction of rotational coronary x-ray angiograms is feasible, produces 3D volumetric images that overcome some of the limitations of standard 2D angiography, and is ready for further implementation and study in the clinical environment.
虽然固定视角 X 射线血管造影仍然是冠状动脉疾病解剖成像的主要技术，但二维投影成像的已知局限性可能限制了对 3D 血管和病变的准确定义和特征描述。最近开发的一种方法，使用在 180 度 C 臂旋转和连续对比剂注射期间获得的 X 射线投影图像，并进行 ECG 门控迭代重建，从而创建冠状动脉的 3D 图像。该方法有望提供无需用户交互的高质量冠状动脉 3D 重建，但需要临床评估。
通过将来自同一 23 名患者的 2D 血管造影投影图像与重建的 3D 容积图像进行比较，评估了重建策略，以确定整体图像质量、病变可见度以及与 2D 定量冠状动脉分析的 3D 定量冠状动脉分析比较。大多数生成的 3D 容积图像的评分都很高（66%），并为医生提供了额外的临床信息，例如分叉的完全可视化和无法获得的冠状动脉树视图。真正的阳性病变检测率很高（90%至 100%），而假阳性检测率较低（0%至 8.1%）。最后，3D 定量冠状动脉分析在管腔直径方面与 2D 定量冠状动脉分析具有显著相似性，并提供了不受缩短误差影响的血管节段长度。
旋转冠状动脉 X 射线血管造影的全自动重建是可行的，可生成克服标准 2D 血管造影某些局限性的 3D 容积图像，并且已经准备好进一步在临床环境中实施和研究。
