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冠状动脉血管镜下黄色分级与背向散射积分血管内超声评估脂质斑块的相关性。

Correlation between coronary angioscopy yellow grade and lipid plaque assessment by integrated backscatter intravascular ultrasound.

作者信息

Tanita Atsushi, Sunamura Shinichiro, Ogata Tsuyoshi, Noda Kazuki, Takii Toru, Nitta Yoshio, Yoshida Seijiro, Namiuchi Shigeto

机构信息

Department of Cardiology, Sendai City Medical Center, Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai-shi, Miyagi-ken, 983-0824, Japan.

Department of Cardiovascular Surgery, Sendai City Medical Center, Sendai, Japan.

出版信息

Cardiovasc Interv Ther. 2025 May 27. doi: 10.1007/s12928-025-01133-6.

Abstract

Coronary angioscopy (CAS) enables direct qualitative assessment of the coronary artery lumen, while integrated backscatter intravascular ultrasound (IB-IVUS) provides a quantitative evaluation of coronary plaque tissue characteristics. Despite the utility of both techniques in assessing coronary plaque status, data on the correlation between their findings remain limited. To investigate the association between CAS-derived findings and results obtained through IB-IVUS. This retrospective analysis included 36 patients who underwent both CAS and IB-IVUS during percutaneous coronary intervention (PCI) at our institution. CAS and IB-IVUS were performed on the same coronary artery treated during PCI. Plaques were categorized into four groups based on their yellow color grade using CAS. For the IB-IVUS analysis, measurements were performed at the minimum lumen diameter site of the culprit lesion. A significant correlation was observed between plaque yellowishness and plaque characteristics on IB-IVUS. Higher plaque yellowishness was associated with an increased percentage of all lipid pool (P < 0.01), a greater proportion of attenuated plaque (P < 0.01), and a larger estimated lipid plaque volume (P < 0.01). Additionally, plaques with higher yellowishness grades had significantly thinner fibrous caps (P < 0.01). The findings suggest that higher plaque yellowishness observed via CAS correlates with a larger lipid plaque volume and thinner fibrous caps, as assessed through IB-IVUS.

摘要

冠状动脉血管镜检查(CAS)能够直接对冠状动脉管腔进行定性评估,而背向散射积分血管内超声(IB-IVUS)则可对冠状动脉斑块组织特征进行定量评估。尽管这两种技术在评估冠状动脉斑块状态方面都很有用,但关于它们检查结果之间相关性的数据仍然有限。为了研究CAS检查结果与通过IB-IVUS获得的结果之间的关联。这项回顾性分析纳入了36例在我们机构接受经皮冠状动脉介入治疗(PCI)期间同时接受CAS和IB-IVUS检查的患者。CAS和IB-IVUS在PCI期间治疗的同一冠状动脉上进行。根据CAS使用的黄色等级将斑块分为四组。对于IB-IVUS分析,在罪犯病变的最小管腔直径部位进行测量。观察到斑块黄色程度与IB-IVUS上的斑块特征之间存在显著相关性。较高的斑块黄色程度与所有脂质池百分比增加(P<0.01)、衰减斑块比例更大(P<0.01)以及估计脂质斑块体积更大(P<0.01)相关。此外,黄色等级较高的斑块纤维帽明显更薄(P<0.01)。研究结果表明,通过CAS观察到的较高斑块黄色程度与通过IB-IVUS评估的更大脂质斑块体积和更薄的纤维帽相关。

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