血管内超声对易损斑块评估的研究进展

确定易损斑块的诊断技术正在迅速发展中。血管内超声(IVUS)能够检测和明确斑块的位置以及定量测量斑块负荷。现在正在应用新的IVUS相关技术来评估斑块破裂之前的易损性。最初,IVUS主要用于定性钙化斑块或纤维脂肪斑块,但它在检测脂质丰富的斑块、坏死核心以及血栓方面的能力有限。血管内超声应用方面的最新进展,如逆向散射、小波分析及虚拟组织学侧重于评估和数字转换射频信号,将超声波信号转换成彩色编码从而代表斑块的特点如脂肪、纤维组织、钙化和坏死核心。此外,弹性图利用腔内压力造成其变形的力学性能评估局部组织,因此在评估存在脂质池,并确定高应变区域,血管内超声弹性图可能是一个理想的技术。

Study Progress on Intravascular Ultrasound Evaluation of the Vulnerable Plaque

Diagnostic techniques to identify vulnerable plaques are rapidly evolving.Intravascular ultrasound(IVUS)has the ability to detect and localize plaque as well as quantitate plaque burden.The ability of IVUS to detect vulnerable plaques before rupture is currently being evaluated by novel techniques.Initially,IVUS was shown to be able to characterize plaque broadly as calcified or fibrofatty but was limited in its ability to more precisely detect lipid-rich plaques,necrotic cores,and thrombus.Recent advances in new applications of IVUS,such as integrated backscatter,wavelet analysis,and virtual histology,have focused on evaluating and mathematically transforming the radiofrequency signal from ultrasound waves into a color-coded representation of plaque characteristics such as lipid,fibrous tissue,calcification,and necrotic core.In addition,elastography evaluates local tissue by utilizing mechanical properties of deformation made by luminal pressure.So intravascular elastography may be an ideal technology in evaluating lipid pool and identifying areas of high strain.