A QUANTITATIVE-EVALUATION OF THE 3-DIMENSIONAL RECONSTRUCTION OF PATIENTS CORONARY-ARTERIES

Background: Through extensive training and experience angiographers le arn to mentally reconstruct the three dimensional (3D) relationships o f the coronary arterial branches. Graphic computer technology can assi st angiographers to more quickly visualize the coronary 3D structure f rom limited initial views and then help to determine additional helpfu l views by predicting subsequent angiograms before they are obtained. Methods: A new computer method for facilitating 3D reconstruction and visualization of human coronary arteries was evaluated by reconstructi ng biplane left coronary angiograms from 30 patients. The accuracy of the reconstruction was assessed in two ways: 1) by comparing the vesse l's centerlines of the actual angiograms with the centerlines of a 2D projection of the 3D model projected into the exact angle of the actua l angiogram; and 2) by comparing two 3D models generated by different simultaneous pairs on angiograms. The inter-and intraobserver variabil ity of reconstruction were evaluated by mathematically comparing the 3 D model centerlines of repeated reconstructions. Results: The average absolute corrected displacement of 14,662 vessel centerline points in 2D from 30 patients was 1.64 +/- 2.26 mm. The average corrected absolu te displacement of 3D models generated from different biplane pairs wa s 7.08 +/- 3.21 mm. The intraobserver variability of absolute 3D corre cted displacement was 5.22 +/- 3.39 mm. The interobserver variability was 6.6 +/- 3.1 mm. Conclusions: The centerline analyses show that the reconstruction algorithm is mathematically accurate and reproducible. The figures presented in this report put these measurement errors int o clinical perspective showing that they yield an accurate representat ion of the clinically relevant information seen on the actual angiogra ms. These data show that this technique can be clinically useful by ac curately displaying in three dimensions the complex relationships of t he branches of the coronary arterial tree.