Kume Teruyoshi, Akasaka Takashi, Kawamoto Takahiro, Ogasawara Yasuo, Watanabe Nozomi, Toyota Eiji, Neishi Yoji, Sukmawan Renan, Sadahira Yoshito, Yoshida Kiyoshi
Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
Am J Cardiol. 2006 Jun 15;97(12):1713-7. doi: 10.1016/j.amjcard.2006.01.031. Epub 2006 Apr 21.
We analyzed optical coherence tomographic (OCT) characteristics of different types of coronary thrombi that had been confirmed at postmortem histologic examination. We examined 108 coronary arterial segments of 40 consecutive human cadavers. OCT images of red and white thrombi were obtained and the intensity property of these thrombi was analyzed. Red and white thrombi were found in 16 (17%) and 19 (18%) of the 108 arterial segments, respectively. Red thrombi were identified as high-backscattering protrusions inside the lumen of the artery, with signal-free shadowing in the OCT image. White thrombi were identified as low-backscattering projections in the OCT image. There were no significant differences in peak intensity of OCT signal between red and white thrombi (130+/-18 vs 145+/-34, p=0.12). However, the 1/2 attenuation width of the signal intensity curve, which was defined as the distance from peak intensity to its 1/2 intensity, was significantly different between red and white thrombi (324+/-50 vs 183+/- 42 microm, p<0.0001). A cut-off value of 250 microm in the 1/2 width of signal intensity attenuation can differentiate white from red thrombi with a sensitivity of 90% and specificity of 88%. We present the first detailed description of the characteristics of different types of coronary thrombi in OCT images. Optical coherence tomography may allow us not only to estimate plaque morphology but also to distinguish red from white thrombi.
我们分析了经尸检组织学检查证实的不同类型冠状动脉血栓的光学相干断层扫描（OCT）特征。我们检查了40例连续人类尸体的108个冠状动脉节段。获取了红色和白色血栓的OCT图像，并分析了这些血栓的强度特性。在108个动脉节段中，分别有16个（17%）发现红色血栓，19个（18%）发现白色血栓。红色血栓在OCT图像中被识别为动脉管腔内的高背散射突出物，并伴有无信号阴影。白色血栓在OCT图像中被识别为低背散射突出物。红色和白色血栓之间的OCT信号峰值强度无显著差异（130±18对145±34，p=0.12）。然而，信号强度曲线的1/2衰减宽度（定义为从峰值强度到其1/2强度的距离）在红色和白色血栓之间有显著差异（324±50对183±42微米，p<0.0001）。信号强度衰减的1/2宽度截断值为250微米时，可区分白色和红色血栓，敏感性为90%，特异性为88%。我们首次详细描述了OCT图像中不同类型冠状动脉血栓的特征。光学相干断层扫描不仅可以让我们估计斑块形态，还可以区分红色和白色血栓。
