Kasahara Tetsuharu, Kitahara Hideki, Takou Kenta, Tateishi Kazuya, Saito Yuichi, Kato Ken, Iimori Takashi, Kobayashi Yoshio
Department of Radiology, Chiba University Hospital, Chiba, Japan.
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan.
Cardiovasc Interv Ther. 2025 Apr 3. doi: 10.1007/s12928-025-01124-7.
Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) can assess the amount of lipid core plaque, and the latest generation catheter allows for imaging at several different pullback speeds. The purpose of this study was to investigate the impact of pullback speed on evaluation of lipid core plaque using the latest generation NIRS-IVUS catheter. Patients with coronary artery disease who underwent coronary angiography or percutaneous coronary intervention with NIRS-IVUS examination at 2 different pullback speeds (0.5 and 2.0 mm/sec) for the same vessel were enrolled. The values of lipid core burden index (LCBI) and maxLCBI4mm were compared between the images recorded with pullback speeds of 0.5 and 2.0 mm/sec, and match or mismatch of the location where maxLCBI4mm was detected was investigated. In a total of 286 NIRS-IVUS image sets, the location of maxLCBI4mm measured at 0.5 and 2.0 mm/sec was mismatched in 81 (28.3%) image sets. In comparison by vessel type, 20.8% were mismatched in LAD, 31.1% in LCx, and 37.8% in RCA (p = 0.023). In 205 image sets with matched maxLCBI4mm location, the maxLCBI4mm value at 2.0 mm/sec was significantly greater compared with that at 0.5 mm/sec (348.0 vs. 302.0 in median, p < 0.001). In a substantial proportion of patients, the location of maxLCBI4mm values measured at 0.5 and 2.0 mm/sec was mismatched. In the image sets with matched maxLCBI4mm location, the maxLCBI4mm value at 2.0 mm/sec was significantly greater compared with that at 0.5 mm/sec. These results should be noted when applying the cut-off values of maxLCBI4mm recorded at 2.0 mm/sec.
近红外光谱血管内超声（NIRS-IVUS）可评估脂质核心斑块的数量，最新一代导管能够以几种不同的回撤速度进行成像。本研究的目的是使用最新一代NIRS-IVUS导管，探讨回撤速度对脂质核心斑块评估的影响。纳入因冠状动脉疾病接受冠状动脉造影或经皮冠状动脉介入治疗且在同一血管以两种不同回撤速度（0.5和2.0毫米/秒）进行NIRS-IVUS检查的患者。比较以0.5和2.0毫米/秒回撤速度记录的图像之间的脂质核心负荷指数（LCBI）和最大LCBI4mm值，并研究检测到最大LCBI4mm的位置是否匹配。在总共286个NIRS-IVUS图像集中，81个（28.3%）图像集在0.5和2.0毫米/秒时测量的最大LCBI4mm位置不匹配。按血管类型比较，左前降支（LAD）中20.8%不匹配，左旋支（LCx）中31.1%不匹配，右冠状动脉（RCA）中37.8%不匹配（p = 0.023）。在最大LCBI4mm位置匹配的205个图像集中，2.0毫米/秒时的最大LCBI4mm值显著高于0.5毫米/秒时的值（中位数分别为348.0和302.0，p < 0.001）。在相当一部分患者中，0.5和2.毫米/秒时测量的最大LCBI4mm值位置不匹配。在最大LCBI4mm位置匹配的图像集中，2.0毫米/秒时的最大LCBI4mm值显著高于0.5毫米/秒时的值。在应用2.0毫米/秒记录的最大LCBI4mm临界值时应注意这些结果。
