Diagnostic accuracy of optical coherence tomography for the identification of in-stent fibroatheroma following stent implantation: an ex vivo histological validation study
Diagnostic accuracy of optical coherence tomography for the identification of in-stent fibroatheroma following stent implantation: an ex vivo histological validation study
复制标题
光学相干断层扫描用于识别支架植入后支架内纤维粥样硬化的诊断准确性：离体组织学验证研究
DOI：
10.1007/s10554-020-02125-8
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Shiojima I.
中科院分区：
文献类型：
--
作者：
Shibutani H;Fujii K;Kawakami R;Imanaka T;Kawai K;Tsujimoto S;Matsumura K;Otagaki M;Morishita S;Hashimoto K;Hao H;Hirota S;Shiojima I.
通过体内成像准确识别支架内纤维粥样斑块对于防止支架展开后的晚期追赶现象具有重要的临床意义。本研究调查了光学相干断层扫描（OCT）在支架植入后检测“支架内纤维粥样硬化”的诊断准确性。 对来自 31 个尸检心脏的 50 个支架冠状动脉进行了检查，以比较 OCT 和组织学图像结果。组织学支架内纤维粥样斑块被定义为含有由巨噬细胞浸润产生的无细胞坏死核心的新内膜。 OCT 衍生的支架内纤维粥样斑块由异质图案组成，低信号强度区域后面有不可见的支架支柱。 总共评估了 122 个匹配的 OCT 和组织学横截面。使用组织学结果作为金标准，OCT 衍生的支架内纤维粥样硬化的敏感性、特异性、阳性预测值和阴性预测值分别为 100%、99%、80% 和 100%。 OCT 衍生的支架内纤维粥样斑块假阳性诊断的唯一组织学发现是泡沫细胞积聚，而新内膜表面没有坏死核心。在此分析中，支架内纤维粥样斑块的 OCT 诊断没有明显的假阴性结果。 这项研究证明了基于低信号强度区域后面的支架支柱可视化的 OCT 区分支架内纤维粥样斑块和其他新内膜组织的潜在能力。
The accurate identification of in-stent fibroatheroma by in vivo imaging is clinically important to preventing the late catch-up phenomenon after stent deployment. This study investigated the diagnostic accuracy of optical coherence tomography (OCT) for the detection of “in-stent fibroatheroma” following stent implantation. Fifty stented coronary arteries from the 31 autopsy hearts were examined to compare OCT and histological image findings. A histological in-stent fibroatheroma was defined as a neointima containing an acellular necrotic core generated by macrophage infiltration. OCT-derived in-stent fibroatheroma comprised a heterogeneous pattern with an invisible stent strut behind the low-signal-intensity region. A total of 122 matched OCT and histology cross-sections were evaluated. Using histological findings as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value for OCT-derived in-stent fibroatheroma were 100%, 99%, 80%, and 100%, respectively. The only histological finding underlying the false-positive diagnosis of OCT-derived in-stent fibroatheroma was foam cell accumulation without a necrotic core on the neointimal surface. No false-negative diagnosis of OCT for in-stent fibroatheroma was apparent in this analysis. This study demonstrated the potential capability of OCT based on stent strut visualization behind low-signal-intensity regions to discriminate in-stent fibroatheroma from other neointimal tissues.
登录
查看更多内容
影响因子：
2.3
作者：
Takarada, Shigeho;Imanishi, Toshio;Akasaka, Takashi
通讯作者：
Akasaka, Takashi
影响因子：
24
作者：
Nakazawa, Gaku;Otsuka, Fumiyuki;Nakano, Masataka;Vorpahl, Marc;Yazdani, Saami K.;Ladich, Elena;Kolodgie, Frank D.;Finn, Aloke V.;Virmani, Renu
通讯作者：
Virmani, Renu
影响因子：
3.5
作者：
Allen, Thomas J.;Hall, Andrew;Beard, Paul C.
通讯作者：
Beard, Paul C.
药物洗脱支架部署后支架内再狭窄病变中新内膜组织形态对球囊血管成形术血管反应的影响：光学相干断层扫描分析
影响因子：
1.5
作者：
W. Yamamoto;K. Fujii;S. Otsuji;S. Takiuchi;M. Kakishita;Y. Shimatani;K. Hasegawa;K. Ishibuchi;Hiroto Tamaru;R. Ishii;Shingo Yasuda;Y. Taniguchi;S. Nakabayashi;Hirofumi Kusumoto;Y. Higashino
通讯作者：
Y. Higashino
影响因子：
3.2
作者：
Hashimoto S;Takahashi A;Mizuguchi Y;Yamada T;Taniguchi N;Hata T;Nakajima S
通讯作者：
Nakajima S