Kim In-Cheol, Nam Chang-Wook, Cho Yun-Kyeong, Park Hyoung-Seob, Yoon Hyuck-Jun, Kim Hyungseop, Chung In-Sung, Han Seongwook, Hur Seung-Ho, Kim Yoon-Nyun, Kim Kwon-Bae
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
Int J Cardiol. 2016 Oct 15;221:860-6. doi: 10.1016/j.ijcard.2016.07.080. Epub 2016 Jul 5.
This purpose of this study is to evaluate, concomitantly with quantitative coronary angiography (QCA), the potential discrepancy between frequency domain optical coherence tomography (FD-OCT) and intravascular ultrasound (IVUS) measurements in a phantom coronary model and in human coronary arteries within and outside stented segments.
FD-OCT and IVUS images sequentially obtained from a phantom coronary model and 57 stented human coronary arteries were compared between each other and with QCA.
Lumen area (LA) by IVUS was 10.1% larger (6.43±0.09mm(2)) while by FD-OCT was similar (5.78±0.09mm(2)) to actual phantom LA (5.72mm(2)); IVUS vs. FD-OCT stent area (SA) was 4.2% larger. In human coronary artery, diameter by QCA was smaller than by IVUS and OCT in reference (by 10.5% and 3.5%, both p<0.001) and stented (3.6%, p<0.001; and 1.7%, p=0.012) segments. IVUS vs. FD-OCT distal reference LA was significantly larger (6.19±2.18mm(2) vs. 5.49±2.49mm(2), p<0.001, respectively), and SA was numerically larger (7.42±2.28mm(2) vs. 7.22±2.48mm(2), p=0.059) with larger discrepancy in reference (11.3%) than stented (2.7%) segments. IVUS vs. FD-OCT correlation for diameter was significantly higher for stented than reference segments (R(2)=0.8670 vs. 0.7351, p=0.047), while numerically higher for area (R(2)=0.8663 vs. 0.7806, p=0.157).
In phantom model and human coronary arteries, IVUS vs. FD-OCT measurements were larger, particularly in non-stented than stented segments, and diameter was smaller by QCA vs. IVUS or FD-OCT. Despite undefined clinical significance, said discrepancy warrants consideration.
本研究的目的是在体模冠状动脉模型以及支架植入段内外的人体冠状动脉中，与定量冠状动脉造影（QCA）同时评估频域光学相干断层扫描（FD-OCT）和血管内超声（IVUS）测量之间的潜在差异。
对从体模冠状动脉模型和57例植入支架的人体冠状动脉中依次获取的FD-OCT和IVUS图像相互之间以及与QCA进行比较。
IVUS测量的管腔面积（LA）比实际体模LA（5.72mm²）大10.1%（6.43±0.09mm²），而FD-OCT测量的管腔面积与之相似（5.78±0.09mm²）；IVUS测量的支架面积（SA）比FD-OCT大4.2%。在人体冠状动脉中，QCA测量的参考段和支架植入段的直径均小于IVUS和OCT测量值（参考段分别小10.5%和3.5%，均p<0.001；支架植入段分别小3.6%，p<0.001；和1.7%，p=0.012）。IVUS与FD-OCT测量的远端参考段LA明显更大（分别为6.19±2.18mm² 对5.49±2.49mm²，p<0.001），SA数值上也更大（7.42±2.28mm² 对7.22±2.48mm²，p=0.059），参考段的差异（11.3%）大于支架植入段（2.7%）。IVUS与FD-OCT测量直径的相关性在支架植入段明显高于参考段（R²=0.8670对0.7351，p=0.047），而面积相关性数值上更高（R²=0.8663对0.7806，p=0.157）。
在体模模型和人体冠状动脉中，IVUS与FD-OCT测量值更大，尤其是在非支架植入段比支架植入段更大，且QCA测量的直径小于IVUS或FD-OCT测量值。尽管临床意义尚不明确，但上述差异值得考虑。
