Coronary artery imaging with intravascular high-frequency ultrasound.

Potkin, Benjamin N.; Bartorelli, Antonio L.; Gessert, James M.; Neville, Richard F.; Almagor, Yaron; Roberts, William C.; Leon, Martin B.

doi:10.1161/01.cir.81.5.1575

Cited by 540 publications

(173 citation statements)

References 30 publications

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“…MRI and intravascular ultrasound are promising technologies for directly imaging plaque morphology. 7,8 For the evaluation of dynamic mechanics, arterial elasticity has been determined by measuring the pulse wave velocity 9 and rough change in the diameter of the artery. 10,11 However, a method to detect the vulnerability of atherosclerotic plaque with sufficient accuracy has not yet been reported.…”

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confidence: 99%

Elasticity Imaging of Atheroma With Transcutaneous Ultrasound

et al. 2003

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Background-Knowledge of the physical properties of atherosclerotic plaque is essential when evaluating its vulnerability in a clinical setting. Such knowledge, however, is still difficult to obtain with the various approaches developed to date. Methods and Results-This article describes a noninvasive method for evaluating the regional elasticity (the elastic modulus in the circumferential direction) of tissue surrounding atherosclerotic plaque in which a novel phased tracking method is applied to measure minute changes in thickness of each of the multiple layers of the arterial wall during one heartbeat. By comparing the pathological findings with the distribution of elasticity, average elasticity of lipid and that of a mixture of smooth muscle and collagen fiber can be determined. On the basis of these reference parameters, each point is statistically categorized as lipid, mixture, or other. Thus, the plaque is electronically stained using transcutaneous ultrasound. By applying the method to the common carotid arteries, the presence of thin collagen fiber was clarified along the arterial axis for normal subjects, whereas soft inclusion of lipid was found for every plaque in subjects with hyperlipidemia. Conclusion-This

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confidence: 99%

Elasticity Imaging of Atheroma With Transcutaneous Ultrasound

et al. 2003

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“…Several studies have shown excellent correlations between the lumen cross-sectional area measured from ul- trasound images compared with direct measurements from histologic cross-sections [1,5,6,8,9]. In addition, an in vitro study using acrylamide casts of a phantom model has demonstrated that contrast angiography overestimates the true lumen cross-sectional area compared with intravascular ultrasound when the lumen is not elliptical but irregular experienced interventional angiographers are impressed by the huge amount of residual atheroma that remains at the site of balloon angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Intravascular ultrasound imaging following balloon angioplasty

et al. 1991

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Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality.Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation.

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“…O seu limite interno, isto é, a transição entre a camada média e a adventícia, é bem visível ao ultra-som, sendo denominada membrana elástica externa. Entretanto, os limites externos da adventícia são imprecisos ao ultrasom, pois os tecidos periadventiciais se confundem com os da adventícia, por apresentar em quantidades semelhantes de colágeno e elastina 5,[8][9][10] .…”

Section: -Interpretação Do Ultra-som Intracoronarianounclassified

“…O ultra-som intracoronariano é uma técnica tomográfi-ca que permite o estudo in vivo da parede vascular normal, dos componentes da placa aterosclerótica e das caracterís-ticas quantitativas e qualitativas envolvidas no ateroma 1,5 . No campo da pesquisa, o ultra-som intracoronariano trouxe contribuições incontestes para o melhor conhecimento da doença aterosclerótica e do fenômeno da reestenose após a realização de intervenção coronariana percutânea 6 .…”

Section: -Introduçãounclassified