The coronary tree expert (CORTEX) analyzer, which is a vision system for the description of the bidimensional shape and position of coronary vessels using standard nonsubtracted radiographic images, is described. A bottom-up approach was used to deal with the typical characteristics of medical images, such as structural and nonstructural noise and complexity and variability of biological shapes. On these grounds, grouping criteria were utilized to produce intermediate image representations with an increasing complexity in a hierarchical manner (from edge points to curves, segments, bars, and finally to vessels and their mutual relations). In this way, uncertain, inconsistent, and deficient information was efficiently processed. The evaluation of CORTEX segmentation is also performed according to a signal-detection-theory-like approach.>