Carlier S G, Cespedes E I, Li W, Mastik F, Van Der Steen A F, Bom N, Serruys P W
Erasmus University Rotterdam, Thoraxcentre, The Netherlands.
Semin Interv Cardiol. 1998 Mar;3(1):21-9.
We present the potentials of a novel method of intracoronary flow visualization and quantification that is based on conventional intravascular ultrasound (IVUS) imaging catheters. The quantification of flow is obtained from analysis of the rate of decorrelation of digitized radiofrequency ultrasound echo signals. Flow information is superimposed on the IVUS image using a colour scale. Integration of the blood velocity components normal to the scan plane permits calculation of the volume flow. Validation using IVUS and electromagnetic (EM) flowmeter recordings were obtained in vivo from instrumented pigs. IVUS flow (IVUS(f)) compared favourably to EM flow (EM(f)): IVUS(f)=1.0 EM(f)+5.72 cc/min, r2=0.98. Clinical results for the first five patients investigated are reported. A Doppler wire was used to measure the flow in four coronary arteries and one renal artery in baseline and hyperaemia conditions. IVUS flow and derived coronary flow reserve (CFR) demonstrated a very good agreement with the data derived from the combination of quantitative angiography and velocity when measured with the Doppler wire (DOP(f)): IVUS(f)=1.01 DOP(f)-20 cc/min, r2=0.90 and IVUS(cfr)=1.03 DOP(cfr)-0.03, r2=0.93. This demonstrates that simultaneous morphological and physiological assessment of coronary or peripheral arteries with one IVUS catheter is feasible. This method should be very useful for the evaluation of intermediate coronary stenoses or the results of revascularization procedures.
我们展示了一种基于传统血管内超声（IVUS）成像导管的新型冠状动脉内血流可视化和定量方法的潜力。血流定量是通过对数字化射频超声回波信号的去相关率分析获得的。血流信息使用颜色标度叠加在IVUS图像上。垂直于扫描平面的血流速度分量的积分允许计算体积流量。使用IVUS和电磁（EM）流量计记录在体内对植入仪器的猪进行了验证。IVUS血流（IVUS(f)）与EM血流（EM(f)）相比表现良好：IVUS(f)=1.0 EM(f)+5.72 cc/min，r2=0.98。报告了对首批五名患者的临床结果。使用多普勒导丝在基线和充血状态下测量了四条冠状动脉和一条肾动脉中的血流。当用多普勒导丝（DOP(f)）测量时，IVUS血流和衍生的冠状动脉血流储备（CFR）与定量血管造影和速度相结合得出的数据显示出非常好的一致性：IVUS(f)=1.01 DOP(f)-20 cc/min，r2=0.90，IVUS(cfr)=1.03 DOP(cfr)-0.03，r2=0.93。这表明使用一根IVUS导管同时对冠状动脉或外周动脉进行形态学和生理学评估是可行的。这种方法对于评估中度冠状动脉狭窄或血运重建手术的结果应该非常有用。
