Guo Jun, Sun Lu, Chen Yun-dai, Tian Feng, Liu Hong-bin, Chen Lian, Sun Zhi-jun, Ren Yi-hong, Jin Qin-hua, Liu Chang-fu, Han Bao-shi, Gai Lu-yue, Yang Ting-shu
Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Apr;40(4):302-6.
To explore the diagnostic accuracy of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in the detection of ex vivo coronary plaques with different compositions compared with histology results.
OCT and IVUS were performed in 15 autopsied heart specimens and the isolated coronary artery was assessed by routine histological processing thereafter. Coronary plaques were classified into 3 types (lipid-rich plaque, calcified plaque and fibrous plaque) according to standard criteria respectively. Sensitivity and specificity for detection of different types of plaque by OCT and IVUS were calculated according histology results.
Seventy seven coronary plaques were analyzed. OCT demonstrated a sensitivity and specificity of 69% and 88% for lipid-rich plaque, 93% and 92% for calcified plaque, 88% and 98% for fibrous plaque. IVUS demonstrated a sensitivity and specificity of 61% and 92%, 98% and 97%, 68% and 90% respectively. The agreement between OCT and IVUS in assessment of coronary plaque was 0.831 (Kappa = 0.72, P < 0.01).
Both OCT and IVUS correctly detected ex vivo coronary plaques and there was a good agreement in assessment of coronary plaques between OCT and IVUS. OCT is superior to IVUS in assessment of fibrous plaque and is similar as IVUS in assessment of calcified plaque.
探讨光学相干断层扫描（OCT）和血管内超声（IVUS）与组织学结果相比，在检测不同成分的离体冠状动脉斑块方面的诊断准确性。
对15个尸检心脏标本进行OCT和IVUS检查，随后通过常规组织学处理评估分离出的冠状动脉。根据标准标准将冠状动脉斑块分别分为3种类型（富含脂质斑块、钙化斑块和纤维斑块）。根据组织学结果计算OCT和IVUS检测不同类型斑块的敏感性和特异性。
分析了77个冠状动脉斑块。OCT对富含脂质斑块的敏感性和特异性分别为69%和88%，对钙化斑块为93%和92%，对纤维斑块为88%和98%。IVUS的敏感性和特异性分别为61%和92%、98%和97%、68%和90%。OCT和IVUS在冠状动脉斑块评估方面的一致性为0.831（Kappa = 0.72，P < 0.01）。
OCT和IVUS均能正确检测离体冠状动脉斑块，且OCT和IVUS在冠状动脉斑块评估方面具有良好的一致性。OCT在纤维斑块评估方面优于IVUS，在钙化斑块评估方面与IVUS相似。
