Validation of an accurate method for three-dimensional reconstruction and quantitative assessment of volumes, lengths and diameters of coronary vascular branches and segments from biplane angiographic projections.

Unlabelled: The goal of the study was the validation of an accurate method for three-dimensional reconstruction and quantitative assessment of volumes, lengths and diameters of coronary vascular branches and segments from biplane angiographic projections.

Methods: The accuracy was tested in a complex phantom. In vivo, inter- and intraobserver agreement were assessed by analysis of routine angiograms. The sensitivity was evaluated using angiograms of patients having diagnostic vasoactive pharmacological intervention. Two-dimensional quantitative coronary angiography (2-D QCA) and 3-D QCA were compared concerning the accuracy of diameter evaluation.

Results: 3-D QCA yields accurate results (< 3% error) even based on nonorthogonal views, provided that projections parallel to the object are avoided. The inter- and intraobserver variability is < or = 5%. Significant (p < 0.01) changes of the volume (36-39%) and the diameter (19-21%) are detected following pharmacological intervention. 2-D QCA and 3-D QCA agree in short matched segments without foreshortening. 2-D QCA is rather sensitive to foreshortening and not suitable for evaluation of diameters of longer branches or total coronaries.

Conclusion: 3-D QCA permits an accurate, reproducible and sensitive comprehensive three-dimensional geometric analysis of the coronaries and is superior to 2-D QCA with respect to extended diameter evaluation.