高清晰度血管内超声与光学相干断层扫描：管腔大小和斑块形态

Journal of the Society for Cardiovascular Angiography & Interventions Pub Date : 2025-05-01 DOI:10.1016/j.jscai.2024.102520

Wei Wu PhD , Shijia Zhao PhD , Akshat Banga MBBS , Yash Vardhan Trivedi MBBS , Vineeth S. Dasari MBBS , Parth Munjal MBBS , Rakshita Ramesh Bhat MBBS , Ruben K.A. Tapia-Orihuela MD , Usama M. Oguz MD , Hammad Zafar MBBS , Haritha Darapaneni MBBS , Nikolaos Spilias MD , Jessica Wagner PhD , Stephen Morin PhD , Amanda DeVos BS , Paul A. Iaizzo PhD , Akiko Maehara MD , Evan S. Shlofmitz DO , Ziad A. Ali MD, DPhil , Emmanouil Brilakis MD, PhD , Yiannis S. Chatzizisis MD, PhD

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引用次数: 0

摘要

复杂的经皮冠状动脉介入治疗依赖于先进的血管内成像技术，如血管内超声（IVUS）和光学相干断层扫描（OCT）。本研究旨在比较最新的高清血管内超声（HD IVUS）和OCT技术在测量冠状动脉管腔尺寸和评估斑块形态方面的准确性。方法以微计算机断层扫描为基础，对8个硅胶模型的HD IVUS和OCT进行比较。我们还比较了9例患者的12条冠状动脉的HD IVUS和OCT。结果在硅胶模型中，最新的HD IVUS （AVVIGO+, Boston Scientific）系统在平均管腔直径（MLD）上比微计算机断层扫描高估了+0.06±0.05 mm。OCT （Ultreon 2.0, Abbott）对MLD的管腔尺寸低估了-0.17±0.06 mm，对于管腔直径≥5.0 mm的管腔尺寸低估更大。在临床病例中，最新的HD IVUS （AVVIGO+）系统与OCT （Ultreon 2.0）相比，MLD的管腔尺寸增加了+0.12±0.11 mm，而早期的HD IVUS （POLARIS, Boston Scientific）系统也显示了与OCT （AptiVue, Abbott）相比，MLD的管腔尺寸增加了+0.26±0.29 mm。以OCT为参照，HD IVUS可精确检测薄纤维帽、夹层、支架支撑等细壁结构。结论最新的HD IVUS （Avvigo+）倾向于高估流明大小，而OCT （Ultreon 2.0）倾向于低估流明大小。实验数据表明，HD IVUS提供了更准确的管腔评估，特别是在较大的冠状动脉中，尽管两种技术在临床环境中表现出相当的总体准确性。

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High-Definition Intravascular Ultrasound Versus Optical Coherence Tomography: Lumen Size and Plaque Morphology

Background

Complex percutaneous coronary interventions rely on advanced intravascular imaging techniques, such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). This study aims to compare the accuracy of the latest high-definition intravascular ultrasound (HD IVUS) and OCT technologies in measuring coronary lumen dimensions and assessing plaque morphology.

Methods

We compared HD IVUS and OCT in 8 silicone models using microcomputed tomography as the ground truth. We also compared HD IVUS vs OCT in 12 coronary arteries from 9 patients.

Results

In the silicone models, the latest HD IVUS (AVVIGO+, Boston Scientific) system overestimated lumen dimensions compared to microcomputed tomography by +0.06 ± 0.05 mm for mean lumen diameter (MLD). OCT (Ultreon 2.0, Abbott) underestimated lumen dimensions by –0.17 ± 0.06 mm for MLD, with the underestimation being greater for lumen diameters ≥5.0 mm. In clinical cases, the latest HD IVUS (AVVIGO+) system yielded larger lumen dimensions compared to OCT (Ultreon 2.0) by +0.12 ± 0.11 mm for MLD, and the earlier HD IVUS (POLARIS, Boston Scientific) system also showed larger lumen dimensions compared to OCT (AptiVue, Abbott) by +0.26 ± 0.29 mm for MLD. Using OCT as the reference, HD IVUS detected fine wall structures with precision, such as a thin fibrous cap, dissection, and stent struts.

Conclusions

The latest HD IVUS (Avvigo+) tends to overestimate lumen size, whereas OCT (Ultreon 2.0) underestimates it. Experimental data suggest HD IVUS provides more accurate lumen assessment, particularly in larger coronary arteries, although both technologies exhibit comparable overall accuracy in the clinical setting.

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来源期刊

Journal of the Society for Cardiovascular Angiography & Interventions Cardiology and Cardiovascular Medicine

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

48 days