Fort S, Freeman N A, Johnston P, Cohen E A, Foster F S
Schulich Heart Centre, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada.
Catheter Cardiovasc Interv. 2001 Mar;52(3):382-92. doi: 10.1002/ccd.1087.
Intravascular ultrasound (IVUS) is an invasive imaging modality, which provides detailed two-dimensional images of blood vessels. There are currently two different types of IVUS catheters available, namely, the phased-array and the mechanical designs. The operating ultrasound frequency of these catheters ranges from 20 to 40 MHz. This study sought to evaluate the image quality, accuracy of diameter and pullback length measurements, and catheter handling characteristics of three different IVUS catheters currently available for clinical use using both in vitro phantom models and in patients undergoing percutaneous coronary intervention (PCI). In gelatin phantom models, image quality assessed on a semiquantitative scale was significantly different between the three IVUS catheters (P = 0.01) with the 40-MHz catheter providing the best images. Accuracy of lumen diameter measurements, when compared to optical microscopy, were similar between the three IVUS catheter designs (all R(2) = 0.99). There were no significant differences in accuracy of pullback length measurements in vitro between the three designs. However, there were differences in the performance of the three IVUS catheters when used for preinterventional imaging in patients undergoing PCI. Both mechanical IVUS catheters were associated with lower procedural, fluoroscopy, and lesion crossing times compared to the phased-array catheter (all P < 0.05). There were no significant differences between the catheters during postinterventional IVUS imaging. There were also small but potentially important differences with regards to clinical events and complications associated with the use of the different IVUS catheters during the PCI procedures, reflecting differences in catheter design.
血管内超声（IVUS）是一种侵入性成像方式，可提供血管的详细二维图像。目前有两种不同类型的IVUS导管，即相控阵和机械设计。这些导管的工作超声频率范围为20至40MHz。本研究旨在使用体外模型和接受经皮冠状动脉介入治疗（PCI）的患者，评估三种目前可用于临床的不同IVUS导管的图像质量、直径测量和回撤长度测量的准确性以及导管操作特性。在明胶模型中，三种IVUS导管在半定量尺度上评估的图像质量有显著差异（P = 0.01），40MHz导管提供的图像最佳。与光学显微镜相比，三种IVUS导管设计的管腔直径测量准确性相似（所有R² = 0.99）。三种设计在体外回撤长度测量准确性方面无显著差异。然而，在接受PCI的患者中用于介入前成像时，三种IVUS导管的性能存在差异。与相控阵导管相比，两种机械IVUS导管的操作、透视和病变通过时间均较短（所有P < 0.05）。介入后IVUS成像期间导管之间无显著差异。在PCI手术期间与使用不同IVUS导管相关的临床事件和并发症方面也存在微小但可能重要的差异，这反映了导管设计的不同。
