Pandian N G, Weintraub A, Kreis A, Schwartz S L, Konstam M A, Salem D N
Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
Circulation. 1990 Jun;81(6):2007-12. doi: 10.1161/01.cir.81.6.2007.
Intravascular ultrasound imaging is a promising new method for assessing vascular morphology. We evaluated the capability of intravascular ultrasound to quantify pulmonary artery (PA) morphology in vitro and explored the feasibility of in vivo PA imaging in animals and humans. In the in vitro study of 15 PA segments, we used a 20-MHz prototype ultrasound catheter. Intravascular ultrasound (y) provided crisp images of PA segments and demonstrated excellent correlations with anatomic measurements (x) in the estimation of luminal area (y = 0.89x + 2.95, r = 0.99, p less than 0.001), luminal diameter (n = 30, y = 0.79x + 0.96, r = 0.92, p less than 0.001), and vessel wall thickness (n = 60, y = 0.65x + 0.33, r = 0.85, p less than 0.001). We subsequently introduced the probe into the PA of 10 dogs and were able to obtain real-time, two-dimensional images of the main PA, its major branches, and farther smaller branches as far as the wedge level. To evaluate the in vivo feasibility of PA imaging in conscious humans, we used a commercially available, 20-MHz intravascular ultrasound (IVUS) catheter in 22 subjects through a femoral or jugular venous sheath at the end of standard diagnostic cardiac catheterization. In 20 subjects, we acquired dynamic, high-resolution, cross-sectional images of the proximal and distal PA. Changes in shape and decreasing luminal area could be clearly recognized as the IVUS catheter reached branching points and as it passed more distally. There were no complications.(ABSTRACT TRUNCATED AT 250 WORDS)
血管内超声成像术是一种很有前景的评估血管形态的新方法。我们评估了血管内超声在体外定量肺动脉(PA)形态的能力,并探讨了在动物和人类体内进行PA成像的可行性。在对15个PA节段的体外研究中,我们使用了一个20兆赫的原型超声导管。血管内超声(y)提供了PA节段的清晰图像,并在管腔面积估计(y = 0.89x + 2.95,r = 0.99,p < 0.001)、管腔直径(n = 30,y = 0.79x + 0.96,r = 0.92,p < 0.001)和血管壁厚度(n = 60,y = 0.65x + 0.33,r = 0.85,p < 0.001)方面与解剖学测量值(x)显示出极好的相关性。随后,我们将探头插入10只狗的PA中,能够获得主PA、其主要分支以及直至楔形水平的更细小分支的实时二维图像。为了评估在清醒人类中进行PA成像的体内可行性,我们在22名受试者的标准诊断性心导管检查结束时,通过股静脉或颈静脉鞘使用了一种市售的20兆赫血管内超声(IVUS)导管。在20名受试者中,我们获取了近端和远端PA的动态、高分辨率横截面图像。当IVUS导管到达分支点并向更远端推进时,形状变化和管腔面积减小可以清晰地识别出来。未出现并发症。(摘要截断于250字)