Fragment reconstruction of coronary arteries by transesophageal echocardiography: a method for visualizing coronary arteries with ultrasound.

Abstract

If transesophageal echocardiography (TEE) is to play a role in coronary diagnostics, satisfactory image documentation of the coronary status is indispensable so that the requirements for validity and quality assurance of a medical examination can be met. Our goal was to develop a suitable and valid procedure for imaging coronary arteries with 2D TEE. After pilot trials and formulation of requirements, a new method of imaging coronary arteries was designed, supported by theoretical and mathematical principles: FRC-TEE, or fragment reconstruction of coronary arteries by means of 2D TEE. The method generates images of successive vessel fragments so that reconstruction in a summation picture is possible. The procedure orients itself to the vessel and ensures proof of identity by permanently following it on the screen. FRC-TEE was evaluated in 12 consecutive patients with an indication for TEE. One hundred percent visualization in proximal, middle, and distal segments was achieved. The total lengths visualized were 10.74+/-2.56 cm for the right and 8.67+/-1.12 cm for the left coronary artery. Stents and stenoses within the vessels were identified convincingly. Because of a technical problem, investigation of the left anterior descending artery was initially avoided. In a pilot trial series (n=12), 6.65+/-0.92 cm of this vessel was imaged. FRC-TEE is a newly developed method of visualizing coronary arteries by means of ultrasound, which permits good pictorial documentation. Initial studies have achieved promising results. Representation of the length of coronary arteries with ultrasound was considerably improved with this technique.