Koyama Kohei, Yoneyama Kihei, Mitarai Takanobu, Kuwata Shingo, Kongoji Ken, Harada Tomoo, Akashi Yoshihiro J
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki-City, Kanagawa, 216-8511, Japan,
Int J Cardiovasc Imaging. 2015 Aug;31(6):1115-23. doi: 10.1007/s10554-015-0676-0. Epub 2015 May 14.
Longitudinal measurement using intravascular ultrasound is limited because the motorized pullback device assumes no cardiac motion. A newly developed intracoronary imaging modality, optical frequency domain imaging (OFDI), has higher resolution and an increased auto-pullback speed with presumably lesser susceptibility to cardiac motion artifacts during pullback for longitudinal measurement; however, it has not been fully investigated. We aimed to clarify the influence of cardiac motion on the accuracy and reproducibility of longitudinal measurements obtained using OFDI and to determine the optimal pullback speed. This ex vivo study included 31 stents deployed in the mid left anterior descending artery under phantom heartbeat and coronary flow simulation. Longitudinal stent lengths were measured twice using OFDI at three pullback speeds. Differences in stent lengths between OFDI and microscopy and between two repetitive pullbacks were assessed to determine accuracy and reproducibility. Furthermore, three-dimensional (3D) reconstruction was used for evaluating image quality. With regard to differences in stent length between OFDI and microscopy, the intraclass correlation coefficient values were 0.985, 0.994, and 0.995 at 10, 20, and 40 mm/s, respectively. With regard to reproducibility, the values were 0.995, 0.996, and 0.996 at 10, 20, and 40 mm/s, respectively. 3D reconstruction showed a superior image quality at 10 and 20 mm/s compared with that at 40 mm/s. OFDI demonstrated high accuracy and reproducibility for longitudinal stent measurements. Moreover, its accuracy and reproducibility were remarkable at a higher pullback speed. A 20-mm/s pullback speed may be optimal for clinical and research purposes.
使用血管内超声进行纵向测量存在局限性，因为电动回撤装置假定心脏无运动。一种新开发的冠状动脉成像方式，即光学频域成像（OFDI），具有更高的分辨率和更快的自动回撤速度，在回撤进行纵向测量时可能对心脏运动伪影的敏感性较低；然而，尚未对其进行充分研究。我们旨在阐明心脏运动对使用OFDI获得的纵向测量的准确性和可重复性的影响，并确定最佳回撤速度。这项离体研究包括在模拟心跳和冠状动脉血流的情况下，在左前降支中段部署的31个支架。使用OFDI以三种回撤速度对支架的纵向长度进行了两次测量。评估了OFDI与显微镜测量的支架长度差异以及两次重复回撤之间的差异，以确定准确性和可重复性。此外，使用三维（3D）重建来评估图像质量。关于OFDI与显微镜测量的支架长度差异，组内相关系数值在10、20和40 mm/s时分别为0.985、0.994和0.995。关于可重复性，在10、20和40 mm/s时的值分别为0.995、0.996和0.996。3D重建显示，与40 mm/s时相比，在10和20 mm/s时图像质量更佳。OFDI在支架纵向测量中显示出高准确性和可重复性。此外，在较高的回撤速度下，其准确性和可重复性也很显著。20 mm/s的回撤速度可能是临床和研究目的的最佳选择。
