PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 12111963

3D MRA coronary axis determination using a minimum cost path approach.

Onno Wink·Alejandro F Frangi·Bert Verdonck·Max A Viergever·Wiro J Niessen
View original source ↗Export metadata ↓

Abstract

A method is introduced to automatically find the coronary axis based on two or more user-defined points, even in the presence of a severe stenosis. The coronary axis is determined by finding a minimum cost path (MCP) in a feature image in which the tubular-like structures are enhanced. The results of the proposed method were compared with manually drawn central axes to estimate the accuracy. In 32 3D TFE-EPI acquisitions of patients and volunteers, 14 right coronary arteries (RCAs), 15 left anterior descending arteries (LADs), and eight left circumflex arteries (LCXs) were manually tracked twice by two operators to determine a reference axis and to assess the inter- and intra-user variability. On average, the maximum distance to the reference axis, based on only two user-defined points, is less than 1.5 mm; the average distance is around 0.65 mm, which is less than the average in-plane resolution. The results of the method are comparable to those of the manual operators.

Explore related subjects

Coronary StenosisCoronary VesselsHumansImage Processing, Computer-AssistedMagnetic Resonance AngiographyComparative StudyJournal ArticleResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Onno Wink, Alejandro F Frangi, Bert Verdonck, Max A Viergever, Wiro J Niessen. 2002. 3D MRA coronary axis determination using a minimum cost path approach.. https://doi.org/10.1002/mrm.10164

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

Accuracy of electrocardiographic-gated versus nongated volumetric intravascular ultrasound measurements of coronary arterial narrowing.

Intravascular ultrasound (IVUS) allows precise measurements of plaque plus media (P+M) volume and neointimal hyperplasia after coronary artery stenting. Conventional IVUS volumetric analysis is performed mostly without electrocardiographically gated acquisition, and the IVUS images are selected at 1-mm intervals, whereas the electrocardiographically gated approach consists of images in end-diastole. The accuracy in the luminal, P+M, and external elastic membrane (EEM) volumes between 2 pullbacks with the electrocardiographically gated and nongated approaches has not previously been compared. In 15 patients, 19 segments were studied with electrocardiographically gated and nongated IVUS systems. Two identical pullbacks were performed with each system using the same IVUS catheter. Volumes of the lumen, EEM, and P+M obtained using the electrocardiographically gated pullback technique did not differ significantly from the corresponding volumes obtained using the nongated pullback technique (lumen: 109.7 +/- 47.7 vs 109.2 +/- 45.0 mm(3), p = NS; EEM: 242.6 +/- 109.2 vs 235.0 +/- 108.1 mm(3), p = NS; P+M: 134.8 +/- 67.7 vs 129.8 +/- 69.1 mm(3), p = NS). No significant differences were seen in changes between 2 electrocardiographically gated and 2 nongated pullbacks (lumen: 0.37 +/- 1.76 vs -0.23 +/- 2.32 mm(3), p = NS; EEM: 0.25 +/- 3.22 vs -0.94 +/- 4.27 mm(3), p = NS; P+M: -0.18 +/- 3.42 vs -0.74 +/- 3.88 mm(3), p = NS). In conclusion, in moderate atherosclerotic or stented coronary arteries, electrocardiographically gated IVUS acquisition is not superior in accuracy to conventional nongated IVUS acquisition.

Coronary Stenosis↗
PubMed2006

EuroSCORE as a predictor of death and myocardial infarction after unprotected left main coronary stenting.

This study aimed to identify the independent predictors of death and myocardial infarction (MI) after unprotected left main coronary artery stenting with bare metal (n = 148) or sirolimus-eluting (n = 176) stents between January 2000 and March 2005. To identify independent predictors of death and nonfatal MI, all available parameters were evaluated. Systemic surgical risk stratification systems such as the EuroSCORE and Parsonnet score were included in the analysis. Clinical information at 9 months was available in 98% of patients (median follow-up 26.3 months). During this period, death/MI occurred in 42 patients (13%). Of the 5 deaths, 4 were related to cardiac and 1 to noncardiac causes. By multivariate Cox regression analysis, a high EuroSCORE (> or =6; hazard ratio 3.4, 95% confidence interval 1.2 to 9.6, p = 0.023), number of stents used (hazard ratio 1.8, 95% confidence interval 1.0 to 3.1, p = 0.042), and treatment with a glycoprotein IIb/IIIa inhibitor (hazard ratio 8.6, 95% confidence interval 2.7 to 27.4, p <0.001) were independent predictors of death/MI. Areas under the receiver-operating characteristic curve of EuroSCORE and number of stents were 0.61 (95% confidence interval 0.52 to 0.70, p = 0.023) and 0.61 (95% confidence interval 0.51 to 0.70, p = 0.028), respectively. In conclusion, high surgical risk estimated by systemic risk stratification of the EuroSCORE appears to be associated with unfavorable outcomes of unprotected left main coronary artery stenting.

Coronary Stenosis↗
PubMed2006

Comparison of the efficacy of direct coronary stenting with sirolimus-eluting stents versus stenting with predilation by intravascular ultrasound imaging (from the DIRECT trial).

A direct coronary stenting technique using drug-eluting stents may decrease drug-eluting stent efficacy due to possible damage to the surface coating of the stent. The DIRECT is a multicenter, prospective, nonrandomized trial designed to evaluate the direct stenting strategy for the sirolimus-eluting Bx-Velocity stent compared with the historical control (SIRIUS trial, stenting with predilation). Volumetric and cross-sectional intravascular ultrasound analyses at 8-month follow-up were performed in 115 patients (DIRECT n= 64, control n = 51). Patient and lesion characteristics were comparable between groups. The DIRECT group achieved an equivalent uniform expansion index, defined as minimum stent area/maximum stent area x 100, compared with the control group (65.9 +/- 11.7 vs 63.1 +/- 12.7, p = NS). At 8-month follow-up, vessel, stent, lumen, and neointimal volume index (volume in cubic millimeters/length in millimeters) and percent neointimal volume were similar between the DIRECT and control groups (vessel volume index 13.9 +/- 4.40 vs 15.0 +/- 3.83; stent volume index 6.83 +/- 2.02 vs 6.94 +/- 2.04; lumen volume index 6.71 +/- 2.04 vs 6.81 +/- 2.07; neointimal volume index 0.14 +/- 0.24 vs 0.16 +/- 0.23; percent neointimal volume 3.73 +/- 6.97 vs 3.14 +/- 5.32, p = NS for all). In addition, in-stent neointimal hyperplasia distribution was significantly smaller near the distal stent edge (0.22 vs 0.098 mm(3)/mm, p = 0.01 for an average neointimal volume index within 3 mm from the distal stent edge). In conclusion, direct coronary stenting with the sirolimus-eluting Bx-Velocity stent is equally effective in terms of uniform stent expansion and long-term quantitative intravascular ultrasound results compared with conventional stenting using predilation. This strategy appears to be associated with less neointimal hyperplasia near the distal stent edge.

Coronary Stenosis↗