Objective: To develop and implement a method for three-dimensional (3D) reconstruction of coronary arteries from conventional monoplane angiograms. Background: 3D reconstruction of conventional coronary angiograms is a promising imaging modality for both diagnostic and interventional purposes. Methods: Our method combines image enhancement, automatic edge detection, an iterative method to reconstruct the centerline of the artery and reconstruction of the diameter of the vessel by taking into consideration foreshortening effects. The X-Ray-based 3D coronary trees were compared against phantom data from a virtual arterial tree projected into two planes as well as computed tomography (CT)-based coronary artery reconstructions in patients subjected to coronary angiography. Results: Comparison against the phantom arterial tree demonstrated perfect agreement with the developed algorithm. Visual comparison against the CT-based reconstruction was performed in the 3D space, in terms of the direction angle along the centerline length of the left anterior descending and circumflex arteries relative to the main stem, and location and take-off angle of sample bifurcation branches from the main coronary arteries. Only minimal differences were detected between the two methods. Inter-and intraobserver variability of our method was low (intra-class correlation coefficients > 0.8). Conclusion: The developed method for coronary artery reconstruction from conventional angiography images provides the geometry of coronary arteries in the 3D space. '

We observed distinct mechanisms of esophageal pressurization and bolus flow patterns in patients with type 2 or type 3 achalasia esophagus compared with control individuals. These findings will increase our understanding of the mechanisms of dysphagia.

This study aimed at investigating the effect of myocardial motion on pulsating blood flow distribution of the left anterior descending coronary artery in the presence of atheromatous stenosis. The moving 3D arterial tree geometry has been obtained from conventional x-ray angiograms obtained during the heart cycle and includes a number of major branches. The geometry reconstruction model has been validated against projection data from a virtual phantom arterial tree as well as with CT-based reconstruction data for the same patient investigated. Reconstructions have been obtained for a number of temporal points while linear interpolation has been used for all intermediate instances. Blood has been considered as a non-Newtonian fluid. Results have been obtained using the same pulse for the inlet blood flow rate but with fixed arterial tree geometry as well as under steady-state conditions corresponding to the mean flow rate. Predictions indicate that myocardial motion has only a minor effect on flow distribution within the arterial tree relative to the effect of the blood pressure pulse.

Studies to date have failed to reveal the anatomical counterpart of the lower esophageal sphincter (LES). We assessed the LES and esophageal hiatus morphology using a block containing the human LES and crural diaphragm, serially sectioned at 50 μm intervals and imaged at 8.2 μm/pixel resolution. A 3D reconstruction of the tissue block was reconstructed in which each of the 652 cross sectional images were also segmented to identify the boundaries of longitudinal (LM) and circular muscle (CM) layers. The CM fascicles on the ventral surface of LES are arranged in a helical/spiral fashion. On the other hand, the CM fascicles from the two sides cross midline on dorsal surface and continue as sling/oblique muscle on the stomach. Some of the LM fascicles of the esophagus leave the esophagus to enter into the crural diaphragm and the remainder terminate into the sling fibers of the stomach. The muscle fascicles of the right crus of diaphragm which form the esophageal hiatus are arranged like a “noose” around the esophagus. We propose that circumferential squeeze of the LES and crural diaphragm is generated by a unique myo-architectural design, each of which forms a “noose” around the esophagus.

BACKGROUND Multichannel intraluminal impedance (MII) is currently used to monitor gastroesophageal reflux and esophageal bolus clearance. We describe a novel methodology to measure maximal luminal CSA during bolus transport from MII measurements. METHODS Studies were conducted in-vitro (test tubes) and in-vivo (healthy subjects). Concurrent MII, HRM, and intraluminal ultrasound (US) were recorded 7 cm above the lower esophageal sphincter. Swallows with two concentrations of saline, 0.1N and 0.5N, of bolus volumes 5cc, 10cc and 15cc were performed. The CSA was estimated by solving two algebraic Ohm’s law equations, resulting from the two saline solutions. The CSA calculated from impedance method was compared with the CSA measured from the intraluminal US images. KEY RESULTS The CSA measured in duplicate from B-mode US images showed a mean difference between the two manual delineations to be near zero, and the repeatability coefficient was within 7.7% of the mean of the two CSA measurements. The calculated CSA from the impedance measurements strongly correlated with the US measured CSA (R2 ≅ 0.98). A detailed statistical analysis of the impedance and US measured CSA data indicated that the 95% limits of agreement between the two methods ranged from −9.1 to 13mm2. The root mean square error (RMS) of the two measurements was 4.8% of the mean US-measured CSA. CONCLUSIONS We describe a novel methodology to measure peak esophageal luminal CSA during peristalsis. Further studies are needed to determine if it is possible to measure patterns of luminal distension during peristalsis across the entire length of the esophagus.