Histological characteristics of plaque with ultrasonic attenuation: a comparison between intravascular ultrasound and histology.
Histological characteristics of plaque with ultrasonic attenuation: a comparison between intravascular ultrasound and histology.
复制标题
超声衰减斑块的组织学特征：血管内超声与组织学的比较。
DOI：
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发表时间：
2007
影响因子：
2.5
通讯作者：
Kiyoshi Yoshida
中科院分区：
文献类型：
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作者：
Ryotaro Yamada;H. Okura;T. Kume;Yoji Neishi;T. Kawamoto;N. Watanabe;E. Toyota;Kiyoshi Yoshida
目标
血管内超声（IVUS）成像上无声影的中等回声斑块被认为是纤维斑块。在经皮冠状动脉介入治疗过程中，这种具有超声衰减的回声斑块可能具有更高的远端血流障碍（慢流/无复流）风险。然而，组织学评价斑块超声衰减尚未进行。本研究通过IVUS评估斑块的超声衰减来评价斑块的组织学特征。
方法
应用IVUS技术，选取36例无钙化的人尸体冠状动脉回声斑块（斑块面积百分比> 40%）标本，分为衰减组、超声衰减斑块组和无衰减斑块组。通过组织学检查将这些斑块分为纤维、纤维脂肪、钙和坏死核心区域。
结果
非衰减组91.7%可见纤维斑块，而衰减组仅68.0%可见纤维斑块（P < 0.01）。另一方面，衰减组的纤维脂肪和坏死核心斑块面积百分比显著大于非衰减组（纤维脂肪：16.3 +/- 13.8% vs. 2.7 +/-3.1%，p < 0.01;坏死核心：13.0 +/- 19.4% vs. 3.9 +/-8.0%，p = 0.03）。结论.与无衰减的纤维斑块相比，超声衰减斑块含有更多的纤维脂肪组织和坏死核心。
OBJECTIVES
Intermediate echogenic plaque without acoustic shadow on intravascular ultrasound (IVUS) imaging has been recognized as fibrous plaque. Such echogenic plaque with ultrasonic attenuation may have higher risk for distal flow disturbance (slow flow/no-reflow) during percutaneous coronary intervention. However, histological evaluation of plaque with ultrasonic attenuation has not been performed. This study evaluated the histological characteristics of plaque with ultrasonic attenuation assessed by IVUS.
METHODS
By using IVUS, 36 samples of human cadaveric coronary arterial echogenic plaque (percentage plaque area > 40%) without calcium were selected, and classified into the attenuation group; plaque with ultrasonic attenuation, and the non-attenuation group; plaque without attenuation. These plaques were classified for fibrous, fibrofatty, calcium, and necrotic core areas by histological examination.
RESULTS
True fibrous plaque was found in 91.7% of the non-attenuation group, but only 68.0% of the attenuation group (p < 0.01) . On the other hand, the percentage fibrofatty and necrotic core plaque areas in the attenuation group were significant larger than those in the non-attenuation group (fibrofatty: 16.3 +/- 13.8% vs. 2.7 +/- 3.1%, p < 0.01; necrotic core: 13.0 +/- 19.4% vs. 3.9 +/- 8.0%, p = 0.03). CONCLUSIONS. Plaque with ultrasonic attenuation contains more fibrofatty tissue and necrotic core compared to fibrous plaque without attenuation.
Tanaka, A.、Kawarabayashi, T.、Nishibori, Y.、Sano, T.、Nishida, Y.、Fukuda, D.、Shimada, K.、Yoshikawa, J.：“患者的无复流现象和病变形态
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