Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Northwest Radiology, St. Vincent Health, Indianapolis, Indiana, USA.
Ultrasound Med Biol. 2020 Feb;46(2):216-224. doi: 10.1016/j.ultrasmedbio.2019.10.010. Epub 2019 Nov 26.
Intravascular ultrasound (IVUS) is a proven and rapidly developing imaging modality that can be used for a multitude of both diagnostic and interventional purposes. By allowing for superior intraluminal characterization, compared with angiography, IVUS has emerged as a technically valuable tool in interventional procedures such as transjugular intrahepatic portosystemic shunt/direct intrahepatic portosystemic shunt, venous interventions (May Thurner stenting, inferior vena cava filter placement, recanalization in the setting of chronic venous thrombosis/insufficiency), percutaneous fenestration in the setting of aortic dissection and angioplasty. Additional applications evaluating coronary arteries and plaque morphology have been described, but are outside the scope of this review. In addition to IVUS's merit as a pre- and intra-procedural guidance modality, there are also several advantages compared to the gold standard of angiography which include decreased need for iodinated contrast, decreased radiation exposure and decreased procedural times in certain cases. With current research, such as that aimed at supraharmonic imaging, further improvements in imaging depth, resolution and contrast to noise ratio are on the horizon.
血管内超声（IVUS）是一种经过验证且快速发展的成像方式，可用于多种诊断和介入目的。与血管造影相比，IVUS 能够更好地对管腔内部进行特征描述，因此在经颈静脉肝内门体分流术/直接肝内门体分流术、静脉介入（May Thurner 支架置入术、下腔静脉滤器放置、慢性静脉血栓形成/功能不全时再通）、主动脉夹层血管成形术等介入操作中，IVUS 已成为一种非常有价值的技术工具。此外，还描述了一些评估冠状动脉和斑块形态的额外应用，但这些不在本次综述的范围内。除了作为术前和术中介入指导的优点外，IVUS 与血管造影的金标准相比还有几个优势，包括减少对碘造影剂的需求、减少辐射暴露和在某些情况下减少手术时间。随着目前对谐波成像等方面的研究，成像深度、分辨率和信噪比的进一步提高即将实现。
