Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside Building, Room 3113, Mailstop: Lakeside 5038, Cleveland, OH, 44106, USA.
University of Texas Southwestern, Dallas, TX, USA.
Int J Cardiovasc Imaging. 2020 Jun;36(6):1013-1020. doi: 10.1007/s10554-020-01795-8. Epub 2020 Feb 18.
Optical coherence tomography (OCT) provides excellent image resolution, however OCT optimal acquisition is essential but could be challenging owing to several factors. We sought to assess the quality of OCT pullbacks and identify the causes of suboptimal image acquisition. We evaluated 784 (404 pre-PCI; 380 post-PCI) coronary pullbacks from an anonymized OCT database from our Cardiovascular Imaging Core Laboratory. Imaging of the region-of-interest (ROI-lesion or stented segment plus references) was incomplete in 16.1% pullbacks, caused by pullback starting too proximal (63.7%), inappropriate pullback length (17.1%) and pullback starting too distal (11.4%). The quality of image acquisition was excellent in 36.3% pullbacks; whereas 4% pullbacks were unanalyzable. Pullback quality was most commonly affected by poor blood displacement from inadequate contrast volume (27.4%) or flow (25.6%), followed by artifacts (24.1%). Acquisition mode was 'High-Resolution' (54 mm) in 74.4% and 'Survey' (75 mm) in 25.6% of cases. The 54 mm mode was associated with incomplete ROI imaging (p = 0.020) and inadequate contrast volume (p = 0.035). We observed a substantial frequency of suboptimal image acquisition and identified its causes, most of which can be addressed with minor modifications during the procedure, ultimately improving patient outcomes.
光学相干断层扫描（OCT）提供了出色的图像分辨率，然而 OCT 的最佳采集至关重要，但由于多种因素，可能具有挑战性。我们旨在评估 OCT 拉回的质量，并确定图像采集不佳的原因。我们评估了来自我们心血管成像核心实验室匿名 OCT 数据库的 784 个（404 个 PCI 前；380 个 PCI 后）冠状动脉拉回。由于拉回起点太靠近近端（63.7%）、拉回长度不合适（17.1%）和拉回起点太靠近远端（11.4%），16.1%的拉回中 ROI 病变或支架段的成像不完整。36.3%的拉回图像采集质量优秀；而 4%的拉回不可分析。图像采集质量最常受到血液置换不良的影响，原因是对比度体积不足（27.4%）或血流不足（25.6%），其次是伪影（24.1%）。74.4%的病例采用“高分辨率”（54mm）采集模式，25.6%的病例采用“普查”（75mm）采集模式。54mm 模式与 ROI 成像不完整（p=0.020）和对比度体积不足（p=0.035）有关。我们观察到图像采集不佳的频率相当高，并确定了其原因，其中大部分原因可以在手术过程中进行微小修改来解决，最终改善患者的预后。
