Method for maximising measurements of muscular pulmonary arteries

Using a digitiser for assessing the media and intima of muscular pulmonary arteries, we have previously shown that the most sensible measurements are those of medial and intimal area and that artery size should be defined in terms of the total length of internal elastic lamina. These measurements do not vary with the collapse or constriction of the artery. A cross sectional cut and a well defined internal elastic lamina are essential for measurement using our technique. This study explores methods for obtaining the above three measurements for cross sectionally cut arteries with an ill defined internal elastic lamina, with a view to increasing the number of arteries measured. The methods were tested on three subjects, using arteries for which the true values of the three variables were known. Acceptable estimates of medial and intimal area could be obtained by simply delineating the boundaries of the intima and media and ignoring the crinkles in the elastic laminae. It was also found that muscular pulmonary arteries may not be uniformly collapsed or constricted round the circumference of their walls and that the overall degree of collapse or constriction seemed to be affected by the size of the artery. An acceptable estimate of the total length of an internal elastic lamina was most readily obtained by multiplying the length of the boundary between intima and media by a crinkle factor based on an optical assessment of the amount of crinkling in that internal elastic lamina.