How to open an angiography CD on Windows and play the cine

What makes an angiogram CD different

A CT or MRI disc holds hundreds of single-frame images. A cath-lab disc holds a handful of XA (X-ray angiography) objects, each a multi-frame cine of 15 to 30 frames per second over a few seconds, with contrast flowing through the vessel. The pixel data is typically JPEG-Lossless (DICOM transfer syntax 1.2.840.10008.1.2.4.70) or JPEG 2000, and each frame carries its own timing. A viewer that lacks the codec will fail to open the run; a viewer that lacks cine playback will show frames one at a time, which is useless for judging flow.

The disc also usually carries the lab’s own mini-viewer. On a modern Windows PC it is the least reliable component on the disc, for the reasons covered in our general DICOM CD guide.

Step by step

On any Windows PC, including a locked-down one:

• Open the disc in File Explorer and ignore any AutoRun prompt. Find the DICOMDIR file or the folder containing the runs.
• Launch a viewer that supports multi-frame XA and the JPEG-Lossless codec. If the viewer is portable, run it from your USB or SSD; nothing needs to be installed.
• Open the folder. Each run appears as one series. Select a run and start cine playback; set the frame rate to the acquisition rate shown in the DICOM header (commonly 15 or 30 fps) so timing is true.
• Scrub to the end-diastolic frame with the best contrast fill before measuring. Calibrate using the catheter’s known French size, or a manual calibration, so measurements are in millimetres rather than pixels.
• Measure, compare pre- and post-intervention runs side by side if present, and print or save a report.

Doing it with PortaDICOM

PortaDICOM was shaped around this exact disc. It runs from its own 2 TB SSD with no install and no admin rights, decodes JPEG-Lossless and JPEG 2000 cine from its own engine, flattens each run into one smooth timeline with look-ahead caching, and lets you set the frame rate. Calibrate on the catheter, then measure % diameter stenosis (QCA), count TIMI frames, map the AHA coronary segment and compare pre- and post-PCI runs. The study is also imported into the case library on the drive, so it is searchable later. PortaDICOM is for review and records only. On-screen measurements are operator-confirmed estimates, not a primary diagnostic read; primary diagnosis needs a regulated diagnostic workstation.

Common problems and fixes

• The run opens as still images: the viewer lacks cine playback. Use a viewer with multi-frame support.
• The run will not open at all: the viewer lacks the JPEG-Lossless or JPEG 2000 codec. Check the viewer’s supported transfer syntaxes.
• Playback stutters: the viewer is decoding frame by frame from the optical drive. Copy the folder to the SSD first, or use a viewer that caches ahead.
• Measurements look wrong: you measured on an uncalibrated frame or during foreshortening. Calibrate on the catheter and pick a frame where the segment is perpendicular to the beam.
• Only the report PDF is on the disc: ask the lab for a DICOM export of the runs.

For patients and referring doctors

If you are a patient who was handed the disc, or a GP receiving it, the practical route is the same: a viewer that plays cine. Searches for "angiography CD viewer free download" lead mostly to installers that will not run on work PCs and to the lab’s own viewers, which vary by vendor. The study itself is standard; any capable viewer can read it, and you do not need the lab’s software.