Accurate 3-D reconstruction and statistics for assessment of diffuse coronary artery disease

Atherosclerotic coronary artery disease is associated with functional impairment, expensive treatment and fatal outcome in many patients. Quantitative evaluations on coronary vessel systems are important aids in diagnosis and therapy planning handling this major epidemiological problem. Whereas local obstructions can already be assessed sufficiently, the estimation of diffuse diseases remains difficult. The authors used a highly accurate spatial reconstruction system on biplane angiograms to quantify even diffuse alterations of the coronary morphology. The 3-D models of the coronary trees derived from the angiograms of the different patients were decomposed into sets of subtrees. Evidently a normal coronary tree has a fractal geometry relating branching order with segment dimensions. This property can directly be used to create measures indicating the fractal amount of specific trees. In this way, the stage of diffuse atherosclerosis destroying the fractal geometry can be quantified.<>