ECG-gated three-dimensional intravascular ultrasound: Feasibility and reproducibility of the automated analysis of coronary lumen and atherosclerotic plaque dimensions in humans

• Published in: Circulation (New York, N.Y.) Vol. 96; no. 9; pp. 2944 - 2952
• Main Authors: VON BIRGELEN, C, DE VREY, E. A, MINTZ, G. S, NICOSIA, A, BRUINING, N, LI, W, SLAGER, C. J, ROELANDT, J. R. T. C, SERRUYS, P. W, DE FEYTER, P. J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 04.11.1997
• Subjects: Adult; Aged; Arteriosclerosis - diagnostic imaging; Arteriosclerosis - pathology; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Coronary Vessels - diagnostic imaging; Diagnostic Errors; Electrocardiography; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Reproducibility of Results; Ultrasonography; Sonography; Human; Echocardiography; Cardiovascular disease; Exploration; Endovascular route; Coronary heart disease; Vascular disease; Electrodiagnosis; Three dimensional representation; Atherosclerotic plaque; Atherosclerosis; Electrocardiography; Technique
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.9.2944

Automated systems for the quantitative analysis of three-dimensional (3D) sets of intravascular ultrasound (IVUS) images have been developed to reduce the time required to perform volumetric analyses; however, 3D image reconstruction by these nongated systems is frequently hampered by cyclic artifacts. We used an ECG-gated 3D IVUS image acquisition workstation and a dedicated pullback device in atherosclerotic coronary segments of 30 patients to evaluate (1) the feasibility of this approach of image acquisition, (2) the reproducibility of an automated contour detection algorithm in measuring lumen, external elastic membrane, and plaque+media cross-sectional areas (CSAs) and volumes and the cross-sectional and volumetric plaque+media burden, and (3) the agreement between the automated area measurements and the results of manual tracing. The gated image acquisition took 3.9+/-1.5 minutes. The length of the segments analyzed was 9.6 to 40.0 mm, with 2.3+/-1.5 side branches per segment. The minimum lumen CSA measured 6.4+/-1.7 mm2, and the maximum and average CSA plaque+media burden measured 60.5+/-10.2% and 46.5+/-9.9%, respectively. The automated contour-detection required 34.3+/-7.3 minutes per segment. The differences between these measurements and manual tracing did not exceed 1.6% (SD<6.8%). Intraobserver and interobserver differences in area measurements (n=3421; r=.97 to.99) were <1.6% (SD<7.2%); intraobserver and interobserver differences in volumetric measurements (n=30; r=.99) were <0.4% (SD<3.2%). ECG-gated acquisition of 3D IVUS image sets is feasible and permits the application of automated contour detection to provide reproducible measurements of the lumen and atherosclerotic plaque CSA and volume in a relatively short analysis time.