Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
JACC Cardiovasc Imaging. 2011 Jun;4(6):647-55. doi: 10.1016/j.jcmg.2011.03.013.
The aim of this study was to compare the findings of near-infrared spectroscopy (NIRS), intravascular ultrasound (IVUS) virtual histology (VH), and grayscale IVUS obtained in matched coronary vessel segments of patients undergoing coronary angiography.
Intravascular ultrasound VH has been developed to add tissue characterization to the grayscale IVUS assessment of coronary plaques. Near-infrared spectroscopy is a new imaging technique able to identify lipid core-containing coronary plaques (LCP).
We performed NIRS and IVUS-VH pullbacks in a consecutive series of 31 patients with a common region of interest (ROI) between 2 side branches. For each ROI, we analyzed the chemogram blocks by NIRS, plaque area and plaque burden by grayscale IVUS, and tissue types by IVUS-VH. The chemogram block is a summary metric of a 2-mm vertical slice of the chemogram. The value ranges from 0 to 1 according to the presence of lipids and represents the probability of LCP with a color scale from red (low probability) through orange and tan to yellow (high probability).
Plaque area (mm(2)) increases as percentage VH derived-necrotic core (NC) content (4.6 ± 2.7 vs. 7.4 ± 3.5 vs. 8.6 ± 3.4 vs. 7.9 ± 3.3, grouped in percentage NC quartiles, p<0.001) and chemogram block probability color bin thresholds increase (4.9 ± 3.8 red, 7.3 ± 3.6 orange, 8.1 ± 3.4 tan, and 8.7 ± 3.4 yellow, p<0.001). The correlation between the block chemogram detection of lipid core and percentage NC content by VH was weak (r=0.149). Correction for the presence of calcium does not improve this correlation.
Larger plaque area by grayscale IVUS was more often associated with either elevated percentage VH-NC or LCP by NIRS; however, the correlation between the detection of LCP by NIRS and necrotic core by VH is weak.
本研究旨在比较近红外光谱（NIRS）、血管内超声（IVUS）虚拟组织学（VH）和灰阶 IVUS 在接受冠状动脉造影的患者匹配的冠状动脉节段中的发现。
血管内超声 VH 的发展是为了在灰阶 IVUS 评估冠状动脉斑块的基础上增加组织特征。近红外光谱是一种新的成像技术，能够识别富含脂质核心的冠状动脉斑块（LCP）。
我们对连续 31 例患者的共同感兴趣区域（ROI）进行了 NIRS 和 IVUS-VH 拉回，在两个侧支之间有一个共同的 ROI。对于每个 ROI，我们通过 NIRS 分析化学图块，通过灰阶 IVUS 分析斑块面积和斑块负担，通过 IVUS-VH 分析组织类型。化学图块是化学图垂直切片 2mm 的总结指标。该值根据脂质的存在范围从 0 到 1 变化，表示 LCP 的概率，颜色范围从红色（低概率）到橙色和棕褐色到黄色（高概率）。
斑块面积（mm²）随 VH 衍生坏死核心（NC）含量的百分比增加而增加（4.6±2.7 比 7.4±3.5 比 8.6±3.4 比 7.9±3.3，按 NC 含量百分比四分位数分组，p<0.001），且化学图块概率颜色箱阈值增加（4.9±3.8 红色，7.3±3.6 橙色，8.1±3.4 棕褐色，8.7±3.4 黄色，p<0.001）。VH 检测的脂质核心与 NC 含量百分比之间的相关性较弱（r=0.149）。校正钙的存在并不能改善这种相关性。
灰阶 IVUS 检测到的更大斑块面积与 VH 检测到的更高百分比 VH-NC 或 LCP 更相关；然而，NIRS 检测到的 LCP 与 VH 检测到的坏死核心之间的相关性较弱。
