Abstract:
BACKGROUND:Following percutaneous transluminal coronary angioplasty (PTCA), the extent of vascular injury is underestimated by angiographic assessment. Conventional intracoronary ultrasound (ICUS) imaging provides additional information with regard to the extent of dissections but requires mental reconstruction of consecutive images. Three-dimensional ICUS reconstruction overcomes this limitation and may provide more accurate assessment of the extent of vascular injury. This study compares conventional two-dimensional ICUS imaging to combined two- and three-dimensional ICUS information in the assessment of vascular injury following PTCA. METHODS:Atherosclerotic, human coronary arteries (n=24) were studied in a specially constructed flow system. Balloon dilatation of significant stenoses was performed followed by assessment using two- and three-dimensional ICUS imaging methods. Treated arteries were submitted for histological assessment after pressure fixation. Dissection depth and length measurements were made from obtained images and compared to histomorphometric assessments. RESULTS:Of the 20 arterial segments confirmed histologically to contain dissection, 11 (55%) and 18 (90%) were identified by two-dimensional ICUS and combined two- and three-dimensional ICUS respectively. The kappa values for correlation of dissection type were 0.29 (0.23-0.35) and 0.64 (0.57-0.71) respectively indicating better agreement using combined two- and three-dimensional ICUS. Two-dimensional ICUS consistently underestimated dissection length (3.52+/-1.75 mm compared with 6.54+/-2.42 mm, P<0.001) and depth (0.61+/-0.24 mm compared with 0.92+/-0.32 mm, P=0.001). Combined two- and three-dimensional ICUS produced accurate dissection length (6.13+/-2.29 mm compared with 6.54+/-2.42 mm, P=0.09) and depth (0.86+/-0.32 mm compared with 0.92+/-0.32 mm, P=0.28) estimations. CONCLUSION:Computerized three-dimensional reconstruction of ICUS images provides improved accuracy compared to conventional ICUS imaging in the detection and quantitation of arterial dissection. This technique would be a useful adjunct to angiography for the precise assessment of vascular injury following PTCA.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Palmer ND,Lessells A,Northridge DB,Fox KAdoi
10.1097/01.mca.0000064020.05024.e5subject
Has Abstractpub_date
2003-05-01 00:00:00pages
255-62issue
3eissn
0954-6928issn
1473-5830journal_volume
14pub_type
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journal_title:Coronary artery disease
pub_type: 杂志文章
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journal_title:Coronary artery disease
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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journal_title:Coronary artery disease
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更新日期:2009-09-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2004-03-01 00:00:00
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更新日期:2010-05-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:2010-06-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:2001-03-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章,评审
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更新日期:2001-12-01 00:00:00
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更新日期:2014-06-01 00:00:00