Department of Internal Medicine, Division of Cardiology, Iwate Medical University, Yahaba-cho, Japan.
Department of Cardiology, Iwate Prefectural Ofunato Hospital, Ofunato, Japan.
Int J Cardiovasc Imaging. 2023 Dec;39(12):2599-2607. doi: 10.1007/s10554-023-02955-2. Epub 2023 Sep 30.
The region behind the coronary calcium could not be visualized by intravascular ultrasound (IVUS) because of acoustic shadow. However, some pathological studies have shown that IVUS delineated the vessel border behind thin coronary calcium sheets. This study aimed to reveal whether recent IVUS can visualize the region behind thin coronary calcium sheets. Using 534 cross-sectional optical frequency domain images (OFDI), including severe calcified coronary lesions, calcium sheet thickness was measured by every 1°. Accordingly, the visibility of the vessel border behind the coronary calcium sheet was evaluated using 60-MHz IVUS images, which were longitudinally linked with OFDI ones. After carefully coordinating with the axial position, the association between the IVUS-derived permeability of the coronary calcium sheet and calcium thickness was evaluated. The maximum and mean calcium thickness by OFDI was 0.88 ± 0.39 and 0.62 ± 0.30 mm, respectively. By 60-MHz IVUS, 12.1% of the coronary calcium sheets had permeable segments. Comparing between OFDI and IVUS images, 48.6% of the coronary calcium sheets with maximum thickness ≤ 0.3 mm were sometimes permeable by 60-MHz IVUS, whereas most > 0.5 mm thick calcium sheets were impermeable. In the receiver operating characteristic curve analysis, the best cutoff values for the maximum and mean thickness of permeable calcium were 0.48 and 0.31 mm, respectively. Thus, 60-MHz IVUS can occasionally visualize the region behind a thin coronary calcium sheet. When using 60-MHz IVUS, this finding may be a predictive marker of calcium sheet with a thickness of < 0.5 mm.
血管内超声（IVUS）由于声影而无法显示冠状动脉钙后面的区域。然而，一些病理学研究表明，IVUS 描绘了薄冠状动脉钙层后面的血管边界。本研究旨在揭示最近的 IVUS 是否可以显示薄冠状动脉钙层后面的区域。使用 534 个横截面光学频域图像（OFDI），包括严重钙化的冠状动脉病变，通过每 1°测量钙层厚度。因此，使用与 OFDI 纵向相连的 60MHz IVUS 图像评估冠状动脉钙层后面的血管边界的可见性。在仔细协调轴向位置后，评估 IVUS 衍生的冠状动脉钙层通透性与钙厚度之间的相关性。通过 OFDI 获得的最大和平均钙厚度分别为 0.88±0.39 和 0.62±0.30mm。通过 60MHz IVUS，12.1%的冠状动脉钙层有可渗透的节段。将 OFDI 和 IVUS 图像进行比较，48.6%最大厚度≤0.3mm 的冠状动脉钙层有时可以通过 60MHz IVUS 显示可渗透，而大多数>0.5mm 厚的钙层是不可渗透的。在接受者操作特征曲线分析中，可渗透钙的最大和平均厚度的最佳截断值分别为 0.48 和 0.31mm。因此，60MHz IVUS 偶尔可以显示薄冠状动脉钙层后面的区域。当使用 60MHz IVUS 时，这一发现可能是厚度<0.5mm 的钙层的预测标志物。
