Unified three-dimensional images of myocardial perfusion and coronary angiography

Introduction and objetives. In everyday clinical practice, the cardiologist needs to integrate anatomical and functional information from patients with coronary artery disease. The aim of this study is to present a way to unify, in three-dimensional images, anatomical information from coronary angiography with physiological information from myocardial perfusion scintigraphy. Methods. Three patients with one-vessel disease (left anterior descending, right coronary and left circumflex arteries, respectively) scheduled for percutaneous coronary revascularization were selected. Two-dimensional angiographic images were obtained before and after revascularization. Tc-99m-tetrofosmin was administered during coronary occlusion and tomographic images corresponding to the occlusion were detected after coronary dilatation. Control rest scintigraphic images were obtained after two days. The three-dimensional coronary tree from coronary angiography was superposed on the epicardial contours of the myocardial perfusion images following a method of our own. Results. A correct three-dimensional reconstruction of myocardial contour and coronary tree was achieved for each patient. The three-dimensional unified images showed excellent concordance between the extent of perfusion defects and the anatomic distribution of the occluded vessel. Conclusions. Three-dimensional unification of myocardial perfusion images and coronary angiography is technically possible. This technology integrates anatomical and functional information to facilitate the cardiologist's decision-making and so improve coronary patient management.