Quantitative analysis of coronary arteriograms by microprocessor cinevideodensitometry

Abstract

A rapid microprocessor technique for mesuring the cross‐sectional area, diameter, and relative percentage stenosis of coronary atherosclerotic lesions by cinevideodensitometric analysis was developed and validated. Video images of projected 35‐mm coronary arteriographic cine frames were analyzed from cinevideodensitometric profile curves recorded for the catheter shaft, normal artery, and stenotic segment. In radiographic phantom studies of calibrated, contrast‐filled, plexiglass cylinders, cinevideodensitometric measurements correlated linearly with percentage relative stenosis (r = 0.98; SEE = 4.1%), diameter (r = 0.99; SEE = 0.12 mm), and cross‐sectional area (r = 0.99; SEE = 0.32 mm²). In postmortem studies of two patients dying after coronary arteriography, cross‐sectional areas of arterial segments measured by cinevideodensitometry correlated well (r = 0.99; SEE = 0.71 mm) with areas of acrylic resin casts of the coronary arteries. Intraobserver variability (r = 0.99; SEE = 2.6%) and interobserver variability (r = 0.96; SEE = 5.3%) of cinevideodensitometric measurements of coronary arteriograms were low. Additionally, percentage relative stenosis measured in the right anterior oblique projection correlated well with measurements in the left anterior oblique projection (r = 0.98; SEE = 0.11 mm²) of patients with eccentric stenotic lesions. Lastly, cinevideodensitometric measurements were significantly (p < 0.05) more reproducible than caliper measurements. This inexpensive dedicated microprocessor system provides rapid cinevideodensitometric measurements of coronary arterial dimensions, without requiring manual tracing of arterial segments or the major expense of a mainframe computer system.