title: Accuracy of stent measurements using ECG-gated greyscale intravascular ultrasound images: a validation study.
abstract: Greyscale intravascular ultrasound (IVUS) is an accurate tool for measuring stent dimensions and residual disease at the stent edge. Electrocardiographically (ECG)-gated IVUS is used in evolving second-generation IVUS systems, but this modality provides fewer greyscale cross-sectional images, and its accuracy to measure stent dimensions has not been assessed. This study was designed to validate the use of ECG-gated greyscale IVUS in measuring minimum stent area (MSA), stent length and reference dimensions compared to standard greyscale IVUS data. IVUS imaging was performed after drug-eluting stent implantation in 53 target lesions in 48 patients with acute coronary syndrome. The IVUS catheter was mechanically withdrawn at 0.5 mm/s, standard greyscale images were collected at 10 frames/s, and ECG-gated greyscale images were constructed from R-wave gated images. The MSA measured 6.20 +/- 1.75 mm(2)vs. 5.98 +/- 1.55 mm(2) on standard greyscale and ECG-gated greyscale IVUS, respectively (R(2) = 0.91, p = 0.005). The MSA position (R(2) = 0.66, p = 0.179) and stent length (R(2) = 0.99, p = 0.435) measurements were similar between modalities. Proximal reference vessel area was larger by ECG-gated IVUS, but proximal reference lumen and distal reference measurements were similar. Bland-Altman plots demonstrated good agreement between modalities. In conclusion, ECG-gated greyscale IVUS provides accurate and reliable measurements of stent length, area and reference segment plaque burden after stent implantation and is not inferior to standard greyscale IVUS.
authors.affiliation: The Cardiovascular Research Foundation, Columbia University Medical Center, New York City, NY, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Kaple
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tsujita
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D054855:Drug-Eluting Stents; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*