Ciszewski Michał, Wolny Rafał, Pręgowski Jerzy, Mintz Gary S, Kruk Mariusz, Kępka Cezary, Jastrzębski Jan, Kalinczuk Lukasz, Chmielak Zbigniew, Karcz Maciej, Zalewska Joanna, Demkow Marcin, Witkowski Adam
*Institute of Cardiology, Warsaw, Poland †Cardiovascular Research Foundation, New York, NY.
J Thorac Imaging. 2016 Jan;31(1):49-55. doi: 10.1097/RTI.0000000000000158.
The aim of our study was to compare plaque burden and vessel remodeling of obstructive saphenous vein graft (SVG) lesions as assessed by dual-source computed tomography (DSCT) and intravascular ultrasound (IVUS).
Preintervention DSCT examination and IVUS were performed in consecutive patients before percutaneous treatment of the SVG lesion. SVG vessel and lumen areas were measured with use of DSCT and IVUS at the minimal lumen area (MLA) site and at proximal and distal reference sites. Plaque burden was defined as the ratio of plaque and vessel area. Remodeling index was defined as the ratio of the SVG area at the MLA site to the mean reference SVG area.
Twenty-four obstructive SVG lesions were imaged with DSCT and IVUS before stent implantation in 24 patients. The SVG cross-sectional area at the MLA site measured by IVUS and DSCT was similar (17.0±4.5 vs. 17.3±5.3 mm, P=0.6) and well correlated (R=0.77, P<0.001). Similarly, plaque burden and remodeling index assessments did not differ significantly between the 2 imaging modalities (79.0%±4.0% vs. 81.0%±8.0%, P=0.18, and 1.09±0.22 vs. 1.07±0.32, P=0.7 for IVUS vs. DSCT for plaque burden and remodeling, respectively). The correlation between IVUS-assessed and DSCT-assessed plaque burden and remodeling index was moderate to good (R=0.55, P=0.01 and R=0.77, P<0.001, respectively, for plaque burden and remodeling index).
There is moderate to good correlation between DSCT and IVUS in the assessment of vessel remodeling and plaque burden in obstructive SVG lesions. Noninvasive assessment and monitoring of SVG disease is feasible using DSCT.
我们研究的目的是比较通过双源计算机断层扫描（DSCT）和血管内超声（IVUS）评估的阻塞性大隐静脉桥血管（SVG）病变的斑块负荷和血管重塑情况。
在对SVG病变进行经皮治疗前，对连续的患者进行干预前DSCT检查和IVUS检查。在最小管腔面积（MLA）部位以及近端和远端参考部位，使用DSCT和IVUS测量SVG血管和管腔面积。斑块负荷定义为斑块面积与血管面积之比。重塑指数定义为MLA部位的SVG面积与平均参考SVG面积之比。
24例患者在支架植入前对24处阻塞性SVG病变进行了DSCT和IVUS成像。IVUS和DSCT测量的MLA部位的SVG横截面积相似（17.0±4.5对17.3±5.3mm，P = 0.6）且相关性良好（R = 0.77，P <0.001）。同样，两种成像方式之间的斑块负荷和重塑指数评估无显著差异（IVUS与DSCT的斑块负荷分别为79.0%±4.0%对81.0%±8.0%，P = 0.18；重塑指数分别为1.09±0.22对1.07±0.32，P = 0.7）。IVUS评估与DSCT评估的斑块负荷和重塑指数之间的相关性为中度至良好（斑块负荷和重塑指数的R分别为0.55，P = 0.01和R = 0.77，P <0.001）。
DSCT和IVUS在评估阻塞性SVG病变的血管重塑和斑块负荷方面具有中度至良好的相关性。使用DSCT对SVG疾病进行无创评估和监测是可行的。
