ivus 血管内超声基础和临床

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1、血管内超声基础和临床应用进展IVUS培训IVUS培训血管内超声基础和进展一、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VHIVUS培训RotatingElementDriveShaftMulti-elementArrayTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkTherearetwotypesofimagingsystems:Mechanical(rotatingtransducer)andElectronicArray

2、IVUS培训HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectronicsprocessthesignalTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训ALA=AxialResolutionL=LateralResolutionTheCardiovascularResearchFoundationLenoxHillHeartandVascu

3、larInstituteofNewYorkIVUS培训LowdynamicrangeHighdynamicrangeTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训Intimaldisease(plaque)isdenseandwillappear‘white’Mediaismadeofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventiti

4、ahas‘sheets’ofcollagenthatreflectalotofultrasound(appearswhite)TheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训TheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训CalciumBrightechoes(brighterthantheadventitia)Obs

5、tructsthepenetrationofultrasound(acousticshadowing)onlytheleadingedgeisdetectedandthicknesscannotbedetermined.Resultsinreverberations-theoscillationofultrasoundbetweentransducerandcalciumcausingrepeating‘arcs’IVUS培训80°SuperficialDeepDeepCalciumisquantifiedbymeasuringthe“arc”itencompa

6、ssesCalciumisclassifiedbyitslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclosertotheadventitiathantothelumenTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训FibroticPlaqueAsbrightorbrighterthantheadven

7、titia(hyperechoic)MajorityofatheroscleroticlesionsarefibroticVerydense,fibrousplaquesmaycausesomuchacousticshadowingthattheycouldbemisclassifiedascalcifiedIVUS培训SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycel

8、lularlesion.