Validation of computerized three-dimensional reconstruction of intravascular ultrasound:  measurements of absolute luminal diameter and cross-sectional area in ex vivo human coronary arteries.
Computer based 3-dimensional reconstruction transforms 2-dimensional intravascular ultrasound images into a longitudinal format facilitating analysis of luminal narrowing.  To validate the accuracy of current software in measuring coronary artery diameter and cross-sectional area, in arteries with atherosclerosis, we performed 3-dimensional reconstruction in 10 human pathologic coronary arterial segments of 10-25mm length.  Images were obtained using a 4.8 French catheter with pullback speed of 1mm/sec acquired at 3 frames/sec onto VHS tape.  The data were digitized and intraluminal 3-dimensional reconstruction performed using a voxel-based program.  Pathologic sections were obtained every 3mm, and dimensions were measured with a resolution of 0.01 mm.  Maximum, minimum, and 3 other representative diameters were recorded by an observer blinded to the ultrasound diameters.  Average histo-pathologic diameters were reported, and specimen cross-sectional area was then calculated.


RESULTS
In 53 sections, pathological diameters ranged from 1.4-4.5mm (mean 2.7 +/- 0.68mm) while 3-dimensional reconstructed diameters were 1.9 to 3.8mm (mean 2.6 +/- 0.54mm). Pathologic and ultrasound derived 3-dimensional reconstruction diameters had an excellent correlation (r=0.86, SEE=+/-0.36).  Pathology and 3-dimensional reconstruction cross-sectional area also correlated closely (r=0.88, SEE=+/-1.50). Diameters less than 2.0mm were systematically overestimated and diameters greater than 3.5mm underestimated by 3-dimensional reconstruction.  Most 3 dimensional reconstruction values were within +/- 10% of pathology, but diverged at each diameter extreme, approaching +/- 20%.  Thus, computerized 3-dimensional reconstruction of ultrasound images shows excellent quantification of luminal size in the 2.0-3.5mm range, suggesting important investigative and clinical applications.
Zientek
D M
DM
Rush Heart Institute and Rush Medical College, Chicago, Illinois.
Rodriguez
E R
ER
Liebson
P R
PR
Parrillo
J E
JE
Kennedy
H L
HL
Klein
L W
LW
D001158:Arteries / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002406:Catheterization, Peripheral / Q000379:methods; D004867:Equipment Design; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008955:Models, Cardiovascular; D012984:Software; D014463:Ultrasonography / Q000295:instrumentation