Werner G S, Sold G, Buchwald A, Kreuzer H, Wiegand V
Department of Cardiology, Georg-August-University Goettingen, Germany.
Am Heart J. 1991 Jul;122(1 Pt 1):212-20. doi: 10.1016/0002-8703(91)90779-h.
An intravascular ultrasound catheter system was used in patients to assess the effect of percutaneous transluminal coronary angioplasty. In 14 out of 16 patients, the intravascular ultrasound catheter could be successfully advanced to the site of a previous dilatation. Qualitative assessment of the cross-sectional images revealed intimal thickening and an increase of ultrasound reflectance and calcification at atherosclerotic coronary arteries. A disruption of the obstructing plaque and evidence for local dissections (11 of 14 cases) were observed after angioplasty. The quantitative comparison between angiography and the ultrasound measurement showed a close correlation for vessel sites distant to the dilatation (r = 0.91 for vessel diameter; r = 0.86 for luminal area; p less than 0.001). After angioplasty, the quantitative evaluation of the dilated area was possible in 11 cases. The correlation of angiographic and sonographic measurements of these segments was good for the assessment of the vessel diameter (r = 0.82, p less than 0.001), but poor for the determination of the luminal area (r = 0.48, p = 0.10). This difference reflected the complex morphology of the vessel lumen after angioplasty, which would be better assessed by the cross-sectional sonographic technique than by contrast angiography. The intravascular imaging of coronary arteries provides a new and unique method to obtain information on the plaque morphology and composition, and to assess the local effects of interventional procedures and their complications.
使用血管内超声导管系统对患者进行评估，以观察经皮腔内冠状动脉成形术的效果。16例患者中有14例，血管内超声导管能够成功推进到先前扩张部位。对横截面图像的定性评估显示，在动脉粥样硬化性冠状动脉处存在内膜增厚、超声反射率增加及钙化。血管成形术后观察到阻塞斑块破裂及局部夹层的证据（14例中有11例）。血管造影与超声测量的定量比较显示，在远离扩张部位的血管部位两者密切相关（血管直径r = 0.91；管腔面积r = 0.86；p < 0.001）。血管成形术后，11例患者能够对扩张区域进行定量评估。这些节段血管造影与超声测量在评估血管直径方面相关性良好（r = 0.82，p < 0.001），但在确定管腔面积方面相关性较差（r = 0.48，p = 0.10）。这种差异反映了血管成形术后血管腔形态的复杂性，通过横截面超声技术比通过造影血管造影能更好地评估。冠状动脉的血管内成像提供了一种全新且独特的方法，可获取斑块形态和成分的信息，并评估介入操作的局部效果及其并发症。
