Validation of a three-dimensional intravascular ultrasound imaging technique to assess atherosclerotic burden: potential for improved assessment of cardiac allograft coronary artery disease.
BACKGROUND
Serial analysis of intracoronary ultrasound images is limited by difficulty with spatial registration and inability to assess the full extent of vascular disease. Three-dimensional (3D) imaging of coronary arteries can potentially overcome these limitations.


OBJECTIVE
To assess the feasibility of using a PC-based 3D rendering technique to assess atherosclerotic burden.


METHODS
To define the accuracy of 3D intravascular ultrasound (IVUS) measurements in vitro, six porcine iliac arteries and nine human cadaveric iliac arteries were pressure fixed and imaged with a commercial IVUS system. 3D datasets of the arteries were constructed, and measurements were correlated with histomorphometry. In vivo studies of 53 arterial segments (19 right coronary, 26 anterior descending and eight circumflex) were scanned in 18 patients, one month to nine years post-transplantation and correlated to corresponding angiographic images for the presence of atherosclerosis.


RESULTS
Porcine artery length and volume measurements by IVUS showed a high degree of correlation with histomorphometry measurements (r=0.99, P<0.0003 and r=0.99, P<0.0001, respectively). Human arterial length, total artery volume and lumen volume measurements were similarly correlated (r=0.99, P<0.0001, r=0.99, P<0.0001 and r=0.98, P<0.0001, respectively). For plaque volume, r=0.84, P<0.05. In vivo 3D IVUS scans demonstrated atherosclerotic lesions in nine of 18 patients, compared with five detected by angiography alone.


CONCLUSIONS
3D IVUS imaging allows rapid and accurate measurement of arterial length, volume and plaque dimensions in addition to lumenal area and can demonstrate the full extent of atherosclerotic pathology. Because of its superior reproducibility, this technique may be used to assess the progression of coronary artery disease and allow for more accurate evaluation of interventions aimed at preventing or retarding coronary artery disease.
White
James A
JA
London Health Sciences Centre, London, Ontario, Canada.
Pflugfelder
Peter W
PW
Boughner
Derek R
DR
Kostuk
William J
WJ
D000818:Animals; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D013552:Swine; D018084:Ultrasonography, Interventional