Fatakdawala Hussain, Gorpas Dimitris, Bishop John W, Bec Julien, Ma Dinglong, Southard Jeffrey A, Margulies Kenneth B, Marcu Laura
Department of Biomedical Engineering, University of California Davis, 451 E. Health Sciences Drive, Davis, CA, 95616, USA.
J Cardiovasc Transl Res. 2015 Jun;8(4):253-63. doi: 10.1007/s12265-015-9627-3. Epub 2015 May 1.
This study evaluates the ability of label-free fluorescence lifetime imaging (FLIm) to complement intravascular ultrasound (IVUS) for concurrent visualization of human coronary vessel composition, structure, and pathology. Co-registered FLIm and IVUS data from 16 coronary segments were correlated to eight distinct pathological features including thin-cap fibroatheroma (TCFA). The sensitivity, specificity, and positive predictive value for combined FLIm-IVUS (89, 99, 89 %) were better than FLIm (70, 98, 88 %) and IVUS (45, 94, 62 %) alone in distinguishing between pathologies. FLIm can assess compositional changes in luminal surface through variations in fluorescence lifetime values (<3.5 ns for lipid-rich areas; >4 ns for collagen-rich areas) enabling detection of macrophages in fibrous caps (sensitivity, 86 %) and distinguishing between relatively stable thick-cap fibroatheromas and rupture-prone TCFA (sensitivity, 80 %) amongst other features. Current results demonstrate the potential of FLIm-IVUS as a new intravascular method for improved evaluation of plaques that may subsequently aid in guiding coronary intervention.
本研究评估了无标记荧光寿命成像（FLIm）辅助血管内超声（IVUS）同步可视化人类冠状动脉血管成分、结构及病理情况的能力。来自16个冠状动脉节段的配准FLIm和IVUS数据与包括薄帽纤维粥样瘤（TCFA）在内的8种不同病理特征相关联。在区分不同病理情况时，联合FLIm-IVUS的敏感性、特异性和阳性预测值（分别为89%、99%、89%）优于单独的FLIm（分别为70%、98%、88%）和IVUS（分别为45%、94%、62%）。FLIm可通过荧光寿命值的变化（富含脂质区域<3.5纳秒；富含胶原蛋白区域>4纳秒）评估管腔表面的成分变化，从而检测纤维帽中的巨噬细胞（敏感性为86%），并区分相对稳定的厚帽纤维粥样瘤和易破裂的TCFA（敏感性为80%）等其他特征。当前结果表明，FLIm-IVUS作为一种新的血管内方法，具有改善斑块评估的潜力，随后可能有助于指导冠状动脉介入治疗。
