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1、血管內(nèi)超聲基礎(chǔ)和臨床應(yīng)用進(jìn)展IVUS培訓(xùn)IVUS培訓(xùn)血管內(nèi)超聲基礎(chǔ)和進(jìn)展一、血管內(nèi)超聲基礎(chǔ)二、血管內(nèi)超聲和冠脈造影的關(guān)系三、主要適應(yīng)癥四、什么是VHIVUS培訓(xùn)RotatingElementDriveShaftMulti-elementArrayTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkTherearetwotypesofimagingsystems:Mechanical(rotatingtransducer)andElectronicArrayIVUS培
2、訓(xùn)HighfrequencysoundwavesechooffvesselwallsandaresentbacktosystemSystemelectronicsprocessthesignalTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓(xùn)ALA=AxialResolutionL=LateralResolutionTheCardiovascular ResearchFoundationLenoxHillHeartandVascular Instit
3、uteofNewYorkIVUS培訓(xùn)LowdynamicrangeHighdynamicrangeTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓(xùn)Intimaldisease(plaque)isdenseandwillappear‘white’Mediaismadeofhomogeneoussmoothmusclecellsanddoesnotreflectultrasound(appearsdark)Adventitiahas‘sheets’ofc
4、ollagenthatreflectalotofultrasound(appearswhite)TheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓(xùn)TheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓(xùn)CalciumBrightechoes(brighterthantheadventitia)Obstructsthepenetration
5、ofultrasound(acousticshadowing)onlytheleadingedgeisdetectedandthicknesscannotbedetermined.Resultsinreverberations-theoscillationofultrasoundbetweentransducerandcalciumcausingrepeating‘a(chǎn)rcs’IVUS培訓(xùn)80°SuperficialDeepDeepCalciumisquantifiedbymeasuringthe“arc”itencompassesCalciumisclassifiedby
6、itslocationwithintheplaqueSuperficialcalciumisclosertothelumenthantotheadventitiaDeepcalciumisclosertotheadventitiathantothelumenTheCardiovascular ResearchFoundationLenoxHillHeartandVascular InstituteofNewYorkIVUS培訓(xùn)FibroticPlaqueAsbrightorbrighterthantheadventitia(hyperechoic)Majorityofat
7、heroscleroticlesionsarefibroticVerydense,fibrousplaquesmaycausesomuchacousticshadowingthattheycouldbemisclassifiedascalcifiedIVUS培訓(xùn)SoftPlaqueNotasbrightastheadventitia(hypoechoic)“Soft”referstothelowechogenicity,generallyduetohighlipidcontentinamostlycellularlesion.
