The clinical value of three-dimensional intravascular ultrasound imaging

Two-dimensional (2D) intravascular ultrasound (IVUS) imaging can now be reconstructed into three dimensions from serial 2D images captured following a "pullback" of the IVUS catheter through the target site. Three-dimensional (3D) reconstructions provide "longitudinal" and "volume" images. The former is similar to an angiogram and can be examined in three dimensions by rotating the image around its longitudinal axis, providing clinically useful information during endovascular procedures. The volume view takes longer to create and is not an exact reconstruction, but it provides images that can be rotated into any spatial position. It visualizes the luminal aspect of the vessel particularly well. The clinical value of 3D IVUS is in the diagnosis of vascular disease and the assessment of endovascular interventions. Three-dimensional IVUS, which provides better, more informative images than 2D IVUS, can be particularly useful intraprocedurally in detecting inaccurate deployment of intravascular stents and endoluminal grafts.