The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Clinical Engineering, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Cardiol. 2023 Sep;82(3):194-200. doi: 10.1016/j.jjcc.2023.05.005. Epub 2023 May 18.
Optical coherence tomography (OCT) is becoming the standard imaging modality for percutaneous coronary intervention (PCI) because of its high resolution. To perform appropriate OCT-guided PCI, it is necessary to avoid artefacts and obtain high-quality images. We investigated the relationship between artefacts and the viscosity of contrast media, which were used to remove air before OCT imaging catheter was inserted into guiding catheter.
We retrospectively analyzed every pullback of OCT examinations from January 2020 to September 2021. Cases were divided into two groups according to the type of contrast media used for catheter flushing: low-viscosity (Iopamidol-300, Bayer, Nordrhein-Westfalen, Germany) vs. high-viscosity (Iopamidol-370, Bayer). We evaluated the artefacts and quality of each OCT image and performed ex vivo experiments to compare differences in artefact frequencies using the two contrast media.
A total of 140 pullbacks in the low-viscosity group and 73 pullbacks in the high-viscosity group were analyzed. The percentage of grade 2 and 3 images (with good quality) in the low-viscosity group was significantly lower (68.1 % vs. 94.5 %, p < 0.001). Rotational artefacts were significantly more common in the low-viscosity group (49.3 % vs. 8.2 %, p < 0.001). In multivariate analysis, using low-viscosity contrast media was a significant factor influencing the appearance of rotational artefacts and affecting image quality (odds ratio, 9.42; 95 % confidence interval, 3.58 to 24.8; p < 0.001). In ex vivo experiments, using low-viscosity contrast media was also a significant predictor of artefact occurrence during OCT (p < 0.01).
The viscosity of the contrast agent used while flushing the OCT imaging catheter contributes to the appearance of OCT artefacts.
光学相干断层扫描（OCT）因其分辨率高，已成为经皮冠状动脉介入治疗（PCI）的标准成像方式。为了进行适当的 OCT 引导 PCI，有必要避免伪影并获得高质量的图像。我们研究了伪影与造影剂粘度之间的关系，在将 OCT 成像导管插入引导导管之前，使用造影剂来去除空气。
我们回顾性分析了 2020 年 1 月至 2021 年 9 月期间的每一次 OCT 检查的回撤。根据用于冲洗导管的造影剂类型，将病例分为两组：低粘度（碘帕醇 300，拜耳，北莱茵-威斯特法伦州，德国）与高粘度（碘帕醇 370，拜耳）。我们评估了每个 OCT 图像的伪影和质量，并进行了离体实验，比较了使用两种造影剂时的伪影频率差异。
共分析了低粘度组 140 次回撤和高粘度组 73 次回撤。低粘度组 2 级和 3 级（质量好）图像的百分比明显较低（68.1%比 94.5%，p<0.001）。低粘度组的旋转伪影明显更为常见（49.3%比 8.2%，p<0.001）。多变量分析显示，使用低粘度造影剂是影响旋转伪影出现和影响图像质量的显著因素（比值比，9.42；95%置信区间，3.58 至 24.8；p<0.001）。在离体实验中，使用低粘度造影剂也是 OCT 过程中出现伪影的显著预测因素（p<0.01）。
冲洗 OCT 成像导管时使用的造影剂的粘度会影响 OCT 伪影的出现。
