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)andElectronicArrayIVUS培

2、训HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectronicsprocessthesignalTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训ALA=AxialResolutionL=LateralResolutionTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstit

3、uteofNewYorkIVUS培训LowdynamicrangeHighdynamicrangeTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训Intimaldisease(plaque)isdenseandwillappear‘white’Mediaismadeofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventitiahas‘sheets’ofc

4、ollagenthatreflectalotofultrasound(appearswhite)TheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训TheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训CalciumBrightechoes(brighterthantheadventitia)Obstructsthepenetration

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

6、itslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclosertotheadventitiathantothelumenTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训FibroticPlaqueAsbrightorbrighterthantheadventitia(hyperechoic)Majorityofat

7、heroscleroticlesionsarefibroticVerydense,fibrousplaquesmaycausesomuchacousticshadowingthattheycouldbemisclassifiedascalcifiedIVUS培训SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycellularlesion.