Kaufmann Beat A
Division of Cardiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
Cardiovasc Res. 2009 Sep 1;83(4):617-25. doi: 10.1093/cvr/cvp179. Epub 2009 Jun 3.
Recent advances in our understanding of the pathophysiological mechanisms of atherosclerosis have created the need for better non-invasive imaging of vascular phenotype. Ultrasound is widely available, inexpensive, and well suited for high-throughput screening in populations that are at risk for atherosclerosis. Novel ultrasonic approaches for the diagnosis of vascular changes in atherosclerosis include (1) assessment of plaque composition by evaluation of the backscattering properties of tissue, (2) assessment of the changes in arterial wall biomechanics, (3) assessment of plaque neovascularization, and (4) molecular imaging of vascular phenotype changes on a subcellular level. It is thought that such new imaging methodologies will lead to earlier detection of atherosclerosis, and better assessment of the risk for aggressive disease progression. Novel therapies for atherosclerosis will undoubtedly become available within the next decades, and non-invasive imaging techniques will be needed for cost-efficient application of existing and new drugs.
近年来,我们对动脉粥样硬化病理生理机制的理解取得了进展,这就需要对血管表型进行更好的非侵入性成像。超声检查广泛可用、价格低廉,非常适合对有动脉粥样硬化风险的人群进行高通量筛查。用于诊断动脉粥样硬化血管变化的新型超声方法包括:(1)通过评估组织的背散射特性来评估斑块成分;(2)评估动脉壁生物力学的变化;(3)评估斑块新生血管形成;(4)在亚细胞水平对血管表型变化进行分子成像。人们认为,这种新的成像方法将有助于更早地检测动脉粥样硬化,并更好地评估疾病进展为侵袭性疾病的风险。在未来几十年内,无疑会出现治疗动脉粥样硬化的新型疗法,而现有的和新的药物要实现经济高效的应用,将需要非侵入性成像技术。