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(rotatingtr

2、ansducer)andElectronicArrayIVUS培训HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectronicsprocessthesignalTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训ALA=AxialResolutionL=LateralResolutionTheC

3、ardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训LowdynamicrangeHighdynamicrangeTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训Intimaldisease(plaque)isdenseandwillappear‘white’Mediaisma

4、deofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventitiahas‘sheets’ofcollagenthatreflectalotofultrasound(appearswhite)TheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训TheCardiovascularResearchF

5、oundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训CalciumBrightechoes(brighterthantheadventitia)Obstructsthepenetrationofultrasound(acousticshadowing)onlytheleadingedgeisdetectedandthicknesscannotbedetermined.Resultsinreverberations-theoscillationo

6、fultrasoundbetweentransducerandcalciumcausingrepeating‘arcs’IVUS培训80°SuperficialDeepDeepCalciumisquantifiedbymeasuringthe“arc”itencompassesCalciumisclassifiedbyitslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclo

7、sertotheadventitiathantothelumenTheCardiovascularResearchFoundationLenoxHillHeartandVascularInstituteofNewYorkIVUS培训FibroticPlaqueAsbrightorbrighterthantheadventitia(hyperechoic)MajorityofatheroscleroticlesionsarefibroticVerydense,fibrousplaquesmaycauseso

8、muchacousticshadowingthattheycouldbemisclassifiedascalcifiedIVUS培训SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycellularlesion.