Cardiology Department, Chinese PLA General Hospital, No. 28 Fuxing Road, HaiDian District, Beijing 100853, People's Republic of China.
Int J Cardiovasc Imaging. 2013 Apr;29(4):925-34. doi: 10.1007/s10554-012-0157-7. Epub 2012 Nov 21.
The precision of the measurement of the angulation of coronary stents or lesions using coronary angiography (CA) and computed tomographic angiography (CTA) has not been established, and obtaining a rotating artery tree to measure angulation based on CTA is time-consuming. The aim of this study was to evaluate the utility of a new three-dimensional centerline method that we have developed for the measurement of coronary stent angulation based on CTA and to compare it with other conventional methods. We used the centerline method compacted by means of our new software, the conventional artery rotation method based on CTA and the simple CA method to measure the angulations of phantoms in vitro and stents implanted in patients. The precision and repetition of this new method was compared with those of the other two methods. The angulation values obtained from both the centerline and artery rotation methods based on CTA had high correlation and agreement with the true angulation values measured using a phantom; the 95 % confidence intervals (CIs) for the differences were -0.67° to 0.91° and -0.59° to 2.93°, respectively, while the difference between the value determined using the CA method and the true angulation of the phantoms ranged from 3° to 21.8° (median 8.1°). In clinical coronary stent measurement, the difference between artery rotation and centerline measurement was small (95 % CI -9.0° to 7.6°), and both methods had good repeatability. The time required to complete the measurement was considerably shorter (p < 0.001) using the centerline method than artery rotation method (12.5 ± 1.86 vs. 71.8 ± 13.6 s), while the CA method had poor precision and repeatability in the measurement of clinical stent angulation relative to the methods based on CTA (95 % CI -14.7° to 21.7°). Our three-dimensional centerline method based on CTA for the measurement of angulation was reliable and easy to implement in both clinical and basic research image analysis, and the centerline and conventional artery rotation methods can be used interchangeably. In addition, the value obtained for the coronary stent angulation using the CA method had a large bias.
冠状动脉支架或病变的角度测量的精度使用冠状动脉造影（CA）和计算机断层血管造影（CTA）尚未确定，并且基于 CTA 获得旋转的动脉树来测量角度是耗时的。本研究的目的是评估我们开发的一种新的基于 CTA 的冠状动脉支架角度测量的三维中心线方法的实用性，并将其与其他常规方法进行比较。我们使用新软件压缩的中心线方法、基于 CTA 的常规动脉旋转方法和简单的 CA 方法测量了体外成像和患者植入支架的角度。比较了新方法与其他两种方法的精度和重复性。基于 CTA 的中心线和动脉旋转方法获得的角度值与使用体模测量的真实角度值高度相关和一致；差值的 95％置信区间（CI）分别为-0.67°至 0.91°和-0.59°至 2.93°，而使用 CA 方法确定的值与体模的真实角度相差 3°至 21.8°（中位数 8.1°）。在临床冠状动脉支架测量中，动脉旋转和中心线测量之间的差异较小（95％CI-9.0°至 7.6°），并且两种方法均具有良好的重复性。使用中心线方法完成测量所需的时间明显短于动脉旋转方法（12.5±1.86 秒对 71.8±13.6 秒），而 CA 方法在测量临床支架角度方面的精度和重复性相对较差与基于 CTA 的方法（95％CI-14.7°至 21.7°）。我们基于 CTA 的三维中心线方法用于角度测量是可靠的，并且易于在临床和基础研究图像分析中实施，中心线和常规动脉旋转方法可以互换使用。此外，使用 CA 方法获得的冠状动脉支架角度值存在较大偏差。
