Jeremy R, Hasche E, Sinclair E, Brieger D, Huang H, Waugh R, Bailey B
University of Sydney, Department of Cardiology, Royal Prince Alfred Hospital, NSW.
Aust N Z J Med. 1993 Aug;23(4):362-9. doi: 10.1111/j.1445-5994.1993.tb01436.x.
Contrast angiography provides a silhouette of the arterial lumen, but does not give information about arterial wall structure. Catheter-tip ultrasound transducers can now provide a cross-sectional image of the arterial wall. This study examined the pathological correlation of intravascular ultrasound images and the accuracy of ultrasound measurements of vascular geometry.
Intravascular ultrasound images were obtained with a mechanically rotated catheter-tip transducer and recorded on videotape. Initial validation studies were performed in fresh, post-mortem arterial specimens, which were filled with saline at physiological pressures. Ultrasound images at specific sites were compared with the pathological findings at that site and measurements of luminal diameter were compared with corresponding angiographic measurements. Subsequently, intravascular ultrasound was employed to examine the aorta, ilio-femoral and coronary arteries in patients undergoing balloon angioplasty.
The pathological correlations showed that intravascular ultrasound can detect early initial thickening and mild atherosclerotic lesions that do not result in luminal deformation. Ultrasound images provided definition of calcified, fibrotic and lipid-filled lesions. Ultrasound measurements of luminal diameter correlated well with pathology measurements (r = 0.93), as did ultrasound measurements of plaque area (r = 0.89). The in vivo studies demonstrated that intravascular ultrasound can define atheroma lesions not evident on contrast angiography and permits detailed evaluation of the results of interventions such as balloon angioplasty.
Intravascular ultrasound provides a unique window upon arterial structure and pathology in humans. Ultrasound images allow accurate measurements of vascular geometry and define early atheromatous lesions that are not evident with angiography.
血管造影可显示动脉管腔轮廓，但无法提供动脉壁结构的信息。导管顶端超声换能器现在能够提供动脉壁的横截面图像。本研究探讨了血管内超声图像的病理相关性以及血管几何结构超声测量的准确性。
使用机械旋转的导管顶端换能器获取血管内超声图像，并记录在录像带上。最初在新鲜的尸检动脉标本中进行验证研究，标本在生理压力下充满盐水。将特定部位的超声图像与该部位的病理结果进行比较，并将管腔直径的测量值与相应的血管造影测量值进行比较。随后，对接受球囊血管成形术的患者的主动脉、髂股动脉和冠状动脉进行血管内超声检查。
病理相关性显示，血管内超声能够检测到早期的初始增厚和轻度动脉粥样硬化病变，这些病变不会导致管腔变形。超声图像可清晰显示钙化、纤维化和脂质填充病变。管腔直径的超声测量值与病理测量值相关性良好（r = 0.93），斑块面积的超声测量值也是如此（r = 0.89）。体内研究表明，血管内超声能够明确造影血管造影未显示的动脉粥样硬化病变，并可详细评估球囊血管成形术等干预措施的效果。
血管内超声为观察人体动脉结构和病理提供了一个独特的窗口。超声图像能够准确测量血管几何结构，并明确血管造影未显示的早期动脉粥样硬化病变。
