上市后,多血管外周动脉成像诊断目的的评估比较光学相干断层扫描和血管内超声成像(SCAN)

E. Pavillard
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引用次数: 0

摘要

背景:血管内成像在血管疾病的诊断和提供治疗策略方面发挥着重要作用。两种主要的成像方式是血管内超声(IVUS)和光学相干断层扫描(OCT)。本研究的目的是证明疑似外周血管疾病患者的匹配外周血管段OCT成像与IVUS图像的非劣效性。方法:SCAN研究是一项前瞻性、非劣等性临床研究,收集了12名受试者(平均年龄68 - 10.3岁;10名男性)有血管疾病的症状两种成像系统在确定的节段的远端、中端和近端点测量管腔直径。三名盲法介入放射科医师评估了两种成像方式在识别曼-惠特尼-威尔考克森检测中的质量。通过类内相关(ICC)分析计算阅读器内再现性。结果:OCT对斑块、钙化和血管支架支撑的平均评分明显优于IVUS (p<0.001, p=0.001, p=0.004)。两种成像系统产生的血管壁成分可见性和伪影的平均得分无显著差异(p=0.19, p=0.07)。在两种成像方式之间,血管内三个特定位置的平均管腔直径和面积没有显著差异。研究期间未发现患者受伤、不良反应或设备故障。结论:OCT成像为医生提供了更好的一些血管和斑块特征的可视化,但IVUS和OCT成像都是安全有效的外周血管检查方法,可以对外周血管进行诊断评估,为外周动脉疾病的治疗策略提供必要的信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic Purposes Comparing Optical Coherence Tomography and Intravascular Ultrasound Imaging (SCAN)
Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease. Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying lMann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoringof plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p<0.001, p=0.001, p=0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p=0.19, p=0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during thestudy. Conclusions: Imaging byOCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease.
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