Rasheed Q, Dhawale P J, Anderson J, Hodgson J M
University Hospital of Cleveland, Division of Cardiology, OH 44106.
Am Heart J. 1995 Apr;129(4):631-7. doi: 10.1016/0002-8703(95)90307-0.
The ability to classify lesion composition accurately may be important for selecting or guiding interventional therapy and for understanding the pathophysiologic basis of individual lesions. To assess the usefulness of ultrasound in classifying lesions, intracoronary ultrasound images were obtained from 44 atherosclerotic lesions in patients before directional atherectomy. Lesions were classified by visual analysis and by computer-assisted gray-level statistics. Atherectomy samples were evaluated histologically for elastosis and calcium and quantitatively by morphometric analysis for various tissue components. The computer-assisted quantitative classification agreed well with the findings on visual analysis. Visual and computer-assisted quantitative ultrasound images were found to have distinctive histologic features. Lesions with predominantly echogenic plaque had a larger fraction of dense fibrous, elastic, or calcified tissue. Lesions with predominantly echolucent soft plaque had a greater fraction of loose fibrous, smooth-muscle, thrombotic, or necrotic elements. Thus intracoronary ultrasound allows accurate classification of lesion composition in patients.
准确分类病变成分的能力对于选择或指导介入治疗以及理解个体病变的病理生理基础可能很重要。为了评估超声在病变分类中的作用，在定向旋切术前从患者的44个动脉粥样硬化病变处获取了冠状动脉内超声图像。通过视觉分析和计算机辅助灰度统计对病变进行分类。对旋切样本进行组织学评估以检测弹性组织变性和钙含量，并通过形态计量分析对各种组织成分进行定量分析。计算机辅助定量分类与视觉分析结果高度一致。视觉和计算机辅助定量超声图像具有独特的组织学特征。以强回声斑块为主的病变中，致密纤维、弹性或钙化组织的比例更大。以低回声软斑块为主的病变中，疏松纤维、平滑肌、血栓或坏死成分的比例更大。因此，冠状动脉内超声能够准确分类患者的病变成分。
