Wellnhofer E, Wahle
A, Mugaragu I, Gross J, Oswald H, Fleck E:
International Journal of Cardiac Imaging, Kluwer
Volume 15, Number 5, Page 339-353, October 1999
Abstract: The goal of this study was the validation of an accurate method for three-dimensional reconstruction and quantitative assessment of volumes, lengths and diameters of coronary vascular branches and segments from biplane angiographic projections. Methods: The accuracy was tested in a complex phantom. In-vivo, inter- and intraobserver agreement were assessed by analysis of routine angiograms. The sensitivity was evaluated using angiograms of patients having diagnostic vasoactive pharmacological intervention. Two-dimensional quantitative coronary angiography (2-D QCA) and 3-D QCA were compared concerning the accuracy of diameter evaluation. Results: 3-D QCA yields accurate results (<3% error) even based on non-orthogonal views, provided that projections parallel to the object are avoided. The inter- and interobserver variability is <5%. Significant (p<0.01) changes of the volume (36%-39%) and the diameter (19%-21%) are detected following pharmacological intervention. 2-D QCA and 3-D QCA agree in short matched segments without foreshortening. 2-D QCA is rather sensitive to foreshortening and not suitable for evaluation of diameters of larger branches or total coronaries. Conclusion: 3-D QCA permits an accurate, reproducible and sensitive comprehensive three-dimensional geometric analysis of the coronaries and is superior to 2-D QCA with respect to extended diameter evaluation.
Editorial comment on this paper on pages 355-356 of the same issue