作者：Johan H.C. Reiber, Shengxian Tu, Joan C. Tuinenburg, Gerhard Koning, Johannes P. Janssen, Jouke Dijkstra
单位：Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Shengxian Tu, Joan C Tuinenburg and Gerhard Koning are employed by Medis medical imaging systems bv and have a research appointment at the Leiden University Medical Center (LUMC). Johan HC Reiber is the CEO of Medis medical imaging systems bv and is emeritus professor of medical imaging at the LUMC.
通讯作者: Johan H.C. Reiber, PhD.
联系方式：Division of Image Processing (LKEB), Department of Radiology, Building 1C2-S,Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC Leiden, The Netherlands. Tel:+31 71 526 3935. E-mail: J.H.C.Reiber@lumc.nl
摘要：过去的30年里，冠脉造影定量分析技术（QCA）在临床研究中作为一种客观的、可重复的方法被广泛使用，主要用来评价介入治疗导致的血管直径变化。同时也在必要的时候，作为一种工具为介入治疗医师在介入治疗前后、以及后续治疗跟踪时提供证据。随着心脏支架植入术复杂程度不断增加，相应的技术方法也不断更新。尽管我们早就有了冠脉血管内超声检查术（intravascular ultrasound, IVUS），现在有更先进的射频分析法（radiofrequency analysis）提供了关于血管壁组成的信息。同样的，光学相干断层扫描技术（optical coherence tomography，OCT）提供了关于支架支撑位置以及支架置入术质量的详细信息。对于介入治疗医师来说，把X射线流明技术和血管内成像系统得到的信息收集在一起，是一种很费脑筋的工作。为了更方便的配准造影成像和X射线成像的信息，新的冠脉三维成像技术应运而生。它可以配准从IVUS或OCT中得到的信息，因此在目标血管的各个部位，X射线结果以及从IVUS得到的血管壁信息，以及从OCT得到的支架数据都可以结合在一起了。从冠状动脉三维成像中可以更容易的选择出最佳的血管造影，这就是本篇综述的目的，将过去三十年里发展起来、并经过临床试验证明有效的技术做一个全面的概述。
关键词：冠状动脉疾病；冠脉造影定量分析（Quantitative coronary angiography）；冠脉血管内超声检查术；冠脉内超声（intravascular ultrasound）；光学相干断层扫描(Optical Coherence Tomography)；三维重组；配准
英文原文：
QCA, IVUS and OCT in interventional cardiology in 2011
Johan H.C. Reiber, Shengxian Tu, Joan C. Tuinenburg, Gerhard Koning, Johannes P. Janssen, Jouke Dijkstra
Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Shengxian Tu, Joan C Tuinenburg and Gerhard Koning are employed by Medis medical imaging systems bv and have a research appointment at the Leiden University Medical Center (LUMC). Johan HC Reiber is the CEO of Medis medical imaging systems bv and is emeritus professor of medical imaging at the LUMC.
Corresponding to: Johan H.C. Reiber, PhD. Division of Image Processing (LKEB), Department of Radiology, Building 1C2-S,Leiden University Medical Center (LUMC), PO Box 9600, 2300 RC Leiden, The Netherlands. Tel:+31 71 526 3935. E-mail: J.H.C.Reiber@lumc.nl
Abstract
Over the past 30 years, quantitative coronary arteriography (QCA) has been used extensively as an objective and reproducible tool in clinical research to assess changes in vessel dimensions as a result of interventions, but also as a tool to provide evidence to the interventional ist prior to and after an intervention and at follow-up when necessary. With the increasing complexities of bifurcation stenting, corresponding analytical tools for bifurcation analysis have been developed with extensive reporting schemes. Although intravascular ultrasound (IVUS) has been around for a long time as well, more recent radiofrequency analysis provides additional information about the vessel wall composition; likewise optical coherence tomography (OCT) provides detailed information about the positions of the stent struts and the quality of the stent placement. Combining the information from the X-ray lumenogram and the intravascular imaging devices is mentally a challenging task for the interventionalist. To support the registration of these intravascular images with the X-ray images, 3D QCA has been developed and registered with the IVUS or OCT images, so that at every position along the vessel of interest the luminal data and the vessel wall data by IVUS or the stent strut data by OCT can be combined. From the 3D QCA the selection of the optimal angiographic views can also be facilitated. It is the intention of this overview paper to provide an extensive description of the techniques that we have developed and validated over the past 30 years.
Key words
Coronary artery disease; QCA; IVUS; OCT; 3D reconstruction; Registration
Cardiovasc Diagn Ther 2011 Sep 24. DOI: 10.3978/j.issn.2223-3652.2011.09.03
