OCT(我的课件).ppt

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1、ApplicationofOCTinpercutaneouscoronaryinterventionLiu-yingwucontentBackgroundDefinitionandmechanismHistoryOCTVsIVUSImageidentificationApplicationinPCISummaryBackgroundTherearelotsofmethodstodetectthelesionsofcoronaryarteryForalongtime，coronaryangiography（C

2、AG）isregardedasthe“goldenstandard”foradiagnosisofcoronaryarterydisease（CAD）But,infact…itisnotalwaystrueHereisanexampleFromCAG,thereseemsnodifferenceinsiteAandsiteBButIVUSgivesusanotheraspect…So,whatyouseeisnotalwaystrue!IntraVascularUltrasoundSystemOptical

3、CoherenceTomographySometimes,wehavetolookintothevessel…DefinitionandmechanismOCT:OpticalCoherenceTomographyMechanism:somewhatlikeRadarnearinfraredrayweekcoherentmechanismreflectedwaveHistoryOCTisclinicallyusedforovertenyearseversinceitsbeingintroducedforme

4、dicalpurposein1991MainlyusedinthedepartmentofophthalmologyNowiswidelyusedcomponentBalloonPressureWire2mm3mmBalloonmasterstationIVUSVsOCTGREYpictureCOLORPictureIVUSOCTHighervalidityIVUSVsOCTIVUSOCTEasiertoidentifyOCTVsIVUS(1)techniqueresoluteratefibriccapli

5、pidcorecalcificationthrombusOCT10µm+++++++++++IVUS100µm+++++++parameterOCTIVUSmechanismnearinfraredraysoundImagingspeedfastslowDiameterofimagingcore0.014"0.028"IdentificationofimageeasyrelativelydifficultlearningcurveshortlongOCTVsIVUS(2)parameterOCTIVUSIm

6、agingframe15fps30fpstransmissdepth1–1.5mm4-8mmScanningextent7mm10-15mmBloodblockademustnoOCTVsIVUS(3)ImageidentificationNormalthreelayerstructurefibrousplaqueOpticsbiopsyfibro-calcifiedplaquecalcifiedplaqueRich-lipidplaquethincapfibro-atheroma(TCFA)stablep

7、laqueandvulnerablePlaqueStableplaquevulnerablePlaqueLargelipidcore，thicknessoffabriccaponly50µmAndeasytorupture（80y.o.,M）AnteroseptalAMIErosion(Ulceration)ThrombusWhiteThrombusRedthrombusRed&whitethrombusKumeT,AkasakaT,etal(AmJCardiol97:1713-1717,2006)Redt

8、hrombusProtrusionmasswithshadowProtrusionmasswithoutshadowProtrusionmasswith&withoutshadowWhitethrombusMixedthrombusKuboT,AkasakaT,etal.(JAmCollCardiol50:933-939,2007)StentApplicationinPCIDetectvulnerablePlaq