3-DIMENSIONAL RECONSTRUCTION OF INTRACORONARY ULTRASOUND IMAGES - RATIONALE, APPROACHES, PROBLEMS, AND DIRECTIONS

Although intracoronary ultrasonography allows detailed tomographic ima ging of the arterial wall, it fails to provide data on the structural architecture and longitudinal extent of arterial disease. This informa tion is essential for decision making during therapeutic interventions . Three-dimensional reconstruction techniques offer visualization of t he complex longitudinal architecture of atherosclerotic plaques in com posite display. Progress in computer hardware and software technology have shortened the reconstruction process and reduced operator interac tion considerably, generating three-dimensional images with delineatio n of mural anatomy and pathology. The indications for intravascular ul trasonography will grow as the technique offers the unique capability of providing ultrasonic histology of the arterial wall, and the need f or a three-dimensional display format for comprehensive analysis is in creasingly recognized. Consequently, three-dimensional imaging is bein g rapidly implemented in the catheterization laboratories for guidance of intracoronary interventions and detailed assessment of their resul ts. However exciting the prospects may be, three-dimensional reconstru ctions at present remain partially artificial because the true spatial position of the imaging catheter tip is not recorded, and shifts in i ts location and curves of the arterial lumen result in pseudoreconstru ctions rather than true reconstructions. In this report, we address th e principles of three-dimensional reconstruction with a critical revie w of its limitations. Potential solutions for refinement of this excit ing imaging modality are presented.