O'Brien Andrew, LaCombe Andrew, Stickland Aubrey, Madder Ryan D
Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA.
Glob Cardiol Sci Pract. 2016 Jun 30;2016(2):e201618. doi: 10.21542/gcsp.2016.18.
Intracoronary near-infrared spectroscopy (NIRS) imaging, which is now clinically available in a combined NIRS and intravascular ultrasound catheter, is a novel catheter-based imaging modality capable of identifying lipid core plaque within the coronary arteries of living patients. The present manuscript provides an overview of intracoronary NIRS imaging with a focus on several concepts essential to individuals seeking to better understand this novel imaging modality. One of the major assets of NIRS is that it has been rigorously validated against the gold standard of histopathology and has been shown to accurately identify histologically-proven fibroatheroma. Clinical studies of NIRS have demonstrated its ability to accurately identify large lipid core plaques at culprit lesions across the spectrum of acute coronary syndromes. NIRS has also been shown to detect lesions at increased risk of causing peri-procedural myocardial infarction during PCI. With regards to predicting future risk, NIRS is seemingly capable of identifying vulnerable patients at increased risk of experiencing subsequent patient-level cardiovascular events. In addition to these clinical applications of NIRS, there are several large prospective observational studies underway to determine if NIRS imaging will be able to identify vulnerable plaques at increased risk of triggering site-specific future coronary events. These studies, once completed, are anticipated to provide valuable data regarding the ability of NIRS imaging to identify plaque vulnerability.
冠状动脉近红外光谱（NIRS）成像现已通过NIRS与血管内超声导管相结合的方式应用于临床，它是一种基于导管的新型成像方式，能够识别活体患者冠状动脉内的脂质核心斑块。本手稿概述了冠状动脉NIRS成像，重点介绍了几个对于希望更好理解这种新型成像方式的人来说至关重要的概念。NIRS的主要优势之一在于，它已针对组织病理学的金标准进行了严格验证，并已被证明能够准确识别经组织学证实的纤维粥样瘤。NIRS的临床研究表明，它能够在急性冠状动脉综合征的整个范围内准确识别罪犯病变处的大型脂质核心斑块。NIRS还被证明能够检测出在经皮冠状动脉介入治疗（PCI）期间发生围手术期心肌梗死风险增加的病变。关于预测未来风险，NIRS似乎能够识别出经历后续患者层面心血管事件风险增加的易损患者。除了NIRS的这些临床应用外，目前正在进行几项大型前瞻性观察性研究，以确定NIRS成像是否能够识别触发特定部位未来冠状动脉事件风险增加的易损斑块。这些研究一旦完成，预计将提供有关NIRS成像识别斑块易损性能力的有价值数据。
