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1、血管內超聲基礎和臨床應用進展IVUS培訓IVUS培訓血管內超聲基礎和進展一、血管內超聲基礎二、血管內超聲和冠脈造影的關系三、主要適應癥四、什么是VHIVUS培訓RotatingElementDriveShaftMulti-elementArrayTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkTherearetwotypesofimagingsystems:Mechanical(rotatingtransducer)andElectronicArray
2、IVUS培訓HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectronicsprocessthesignalTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓ALA=AxialResolutionL=LateralResolutionTheCardiovascular ResearchFoundationLenoxHillHeartandVascu
3、lar InstituteofNewYorkIVUS培訓LowdynamicrangeHighdynamicrangeTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓Intimaldisease(plaque)isdenseandwillappear‘white’Mediaismadeofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventiti
4、ahas‘sheets’ofcollagenthatreflectalotofultrasound(appearswhite)TheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓TheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓CalciumBrightechoes(brighterthantheadventitia)Obs
5、tructsthepenetrationofultrasound(acousticshadowing)onlytheleadingedgeisdetectedandthicknesscannotbedetermined.Resultsinreverberations-theoscillationofultrasoundbetweentransducerandcalciumcausingrepeating‘arcs’IVUS培訓80°SuperficialDeepDeepCalciumisquantifiedbymeasuringthe“arc”itencompa
6、ssesCalciumisclassifiedbyitslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclosertotheadventitiathantothelumenTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓FibroticPlaqueAsbrightorbrighterthantheadven
7、titia(hyperechoic)MajorityofatheroscleroticlesionsarefibroticVerydense,fibrousplaquesmaycausesomuchacousticshadowingthattheycouldbemisclassifiedascalcifiedIVUS培訓SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycel
8、lularlesion.
