혈관내 초음파 영상에 의한 형태 및 조직병리 소견 평가 = Geometric Accuracy and Histopathologic Validation of Intravascular Ultrasound Imaging

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Background: To evaluate geometric accuracy of intravascular ultrasound and histopathologic validation of ultrasound and angioscopy we studied postmortem human arterial segments and phantoms in vitro. Method: We used 7 to 9 French fiberoptic angioscopes and 30 MHz intravascular ultrasound imaging catheter. We assessed the area and wall thickness on 9 phantom vessels and 12 arteries with different imaging media and 30 angle of incidence. To evaluate histopathologic validation of ultrasound and angioscopy, the images of 12 normal and 55 abnormal (stable atheroma, disrupted atheroma and thrombi) vessels were compared with histology. Results: Geometric accuracy: The measured area were smaller in blood (7.2-7.6%) and gel (10,8-13.6%) than that of saline. A 30 angle of incidence resulted in 14.2%-16.3% increase in lumen area and 10,6% increase in wall thickness. Ultrasonic wall thickness of human vessels correlated closely with the actual measured thickness (r=0,93). Histopatholgic validation: the sensitivity specifictiy and accuracy of both method were greater than 96% in normal vessel and 90% in stable atheroma. For normal vessel predictive value was better for angioscopy than for ultrasound. For stable atheroma the predictive value were 77%. for angioscopy and 78% for ultrasound due to classification of disrupted atheroma to stable atheroma. For thrombus detection sensitivity was 62% for ultra- sound due to false negative interpretation of lamina clots and atheroma in vessel. Conclusion: With ultrasound measurement, lumen area and wall thickness were accurate when the catheter placement was coaxial. For histopathologic validation, angioscopy and ultrasound images had significant agreement with the results obtained from histology.