血管内超声基础知识ppt培训课件

《血管内超声基础知识ppt培训课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、血管内超声基础知识阜外医院钱杰南方会2008血管内超声基础知识一、血管内超声基础二、血管内超声和冠脉造影的关系三、主要适应症四、什么是VH南方会2008RotatingElementDriveShaftMulti-elementArrayTherearetwotypesofimagingsystems:Mechanical(rotatingtransducer)andElectronicArray南方会2008HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectron

2、icsprocessthesignal南方会2008Intimaldisease(plaque)isdenseandwillappear‘white’Mediaismadeofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventitiahas‘sheets’ofcollagenthatreflectalotofultrasound(appearswhite)南方会2008南方会2008CalciumBrightechoes(brighterthantheadventi

3、tia)Obstructsthepenetrationofultrasound(acousticshadowing)onlytheleadingedgeisdetectedandthicknesscannotbedetermined.Resultsinreverberations-theoscillationofultrasoundbetweentransducerandcalciumcausingrepeating‘arcs’南方会200880°SuperficialDeepDeepCalciumisquantifiedbymeasuringthe“arc”i

4、tencompassesCalciumisclassifiedbyitslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclosertotheadventitiathantothelumen南方会2008FibroticPlaqueAsbrightorbrighterthantheadventitia(hyperechoic)MajorityofatheroscleroticlesionsarefibroticVerydense,

5、fibrousplaquesmaycausesomuchacousticshadowingthattheycouldbemisclassifiedascalcified南方会2008SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycellularlesion.Reducedechodensitymayalsobedueto:necroticzonewithinplaquei

6、ntramuralhemorrhagethrombus南方会2008VulnerablePlaqueFibrousCapLipidCore南方会2008MixedPlaque南方会2008014mmExampleofThrombus南方会2008BasicMeasurements(I)Externalelasticmembrane(EEM)crosssectionalarea(CSA)=totalarterialCSA=‘media’areatracingtheboundarybetweenthedarkmediaandthebrightadventitia(

7、i.e.,theapparentouteredgeofthemediastripe)LumenCSAMaxandminlumendiametersStentCSAMaxandminstentdiametersPlaque+media(P+M)CSA=EEM-LumenCSAinnon-stentedlesions=EEM-stentCSAinstentedlesionsIntimalhyperplasiaCSA=Stent-LumenCSA南方会2008BasicMeasurements(II)Eccentricity=maximum/minimumP+Mthi

8、cknessPlaque