Three-dimensional coronary artery microscopy by intracoronary optical frequency domain imaging.
Three-dimensional coronary artery microscopy by intracoronary optical frequency domain imaging.
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DOI：
10.1016/j.jcmg.2008.06.007
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发表时间：
2008-11
影响因子：
14
通讯作者：
Bouma, Brett E.
中科院分区：
文献类型：
--
作者：
Tearney, Guillermo J.;Waxman, Sergio;Shishkov, Milen;Vakoc, Benjamin J.;Suter, Melissa J.;Freilich, Mark I.;Desjardins, Adrien E.;Oh, Wang-Yul;Bartlett, Lisa A.;Rosenberg, Mireille;Bouma, Brett E.
我们提出了冠状动脉内光学频域成像（OFDI）在人类患者的第一个临床经验。冠状动脉内光学相干断层扫描（OCT）是一种基于导管的光学成像方式，能够提供冠状动脉壁的显微（轴向分辨率~ 7 μm，横向分辨率~ 30 μm）横切面图像。尽管使用OCT成像冠状动脉微结构显示出巨大的前景，但血液会减弱OCT信号，因此需要长时间近端闭塞来筛查长动脉段。OFDI是第二代OCT，能够以更高的帧率获取图像。OFDI速度的提高使得在短暂的非闭塞性盐水清洗后能够快速地对长冠状动脉段进行三维成像。3例患者在冠状动脉内支架置入后获得体积OFDI图像。在左前降支和右冠状动脉进行成像，使用非闭塞性生理盐水清洗，清洗速率为3至4 ml/s，清洗持续时间为3至4 s。成像后，使用先前记录的标准对OFDI数据集进行分割并绘制体积。在所有病例中均获得了良好的动脉壁可视化，在回拉速率为5至20 mm/s的情况下，清晰的观察长度范围为3.0至7.0 cm。在2维和3维中发现了多种显微镜特征，包括薄帽纤维动脉粥样瘤、钙、巨噬细胞、胆固醇晶体、裸露的支架支撑和新生内膜增生的支架。对外直接投资手术没有并发症。我们的研究结果表明，OFDI是一种可行的方法来成像长冠状动脉段的微观结构。鉴于其能够以实用的方式提供显微信息，该技术可能有助于在体内研究人类冠状动脉病理生理，并作为指导冠状动脉疾病管理的临床工具。（中华医学杂志2008；1:752 - 761）
We present the first clinical experience with intracoronary optical frequency domain imaging (OFDI) in human patients. Intracoronary optical coherence tomography (OCT) is a catheter-based optical imaging modality that is capable of providing microscopic (∼7-μm axial resolution, ∼30-μm transverse resolution), cross-sectional images of the coronary wall. Although the use of OCT has shown substantial promise for imaging coronary microstructure, blood attenuates the OCT signal, necessitating prolonged, proximal occlusion to screen long arterial segments. OFDI is a second-generation form of OCT that is capable of acquiring images at much higher frame rates. The increased speed of OFDI enables rapid, 3-dimensional imaging of long coronary segments after a brief, nonocclusive saline purge. Volumetric OFDI images were obtained in 3 patients after intracoronary stent deployment. Imaging was performed in the left anterior descending and right coronary arteries with the use of a nonocclusive saline purge rates ranging from 3 to 4 ml/s and for purge durations of 3 to 4 s. After imaging, the OFDI datasets were segmented using previously documented criteria and volume rendered. Good visualization of the artery wall was obtained in all cases, with clear viewing lengths ranging from 3.0 to 7.0 cm at pullback rates ranging from 5 to 20 mm/s. A diverse range of microscopic features were identified in 2 and 3 dimensions, including thin-capped fibroatheromas, calcium, macrophages, cholesterol crystals, bare stent struts, and stents with neointimal hyperplasia. There were no complications of the OFDI procedure. Our results demonstrate that OFDI is a viable method for imaging the microstructure of long coronary segments in patients. Given its ability to provide microscopic information in a practical manner, this technology may be useful for studying human coronary pathophysiology in vivo and as a clinical tool for guiding the management of coronary artery disease. (J Am Coll Cardiol Img 2008;1:752–61)
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影响因子：
2.8
作者：
Brezinski, ME;Tearney, GJ;Fujimoto, JG
通讯作者：
Fujimoto, JG
影响因子：
4.8
作者：
Kume, Teruyoshi;Akasaka, Takashi;Yoshida, Kiyoshi
通讯作者：
Yoshida, Kiyoshi
影响因子：
37.8
作者：
Finn, Aloke V.;Joner, Michael;Virmani, Renu
通讯作者：
Virmani, Renu
影响因子：
1.5
作者：
Kume, T;Akasaka, T;Yoshida, K
通讯作者：
Yoshida, K
影响因子：
2.9
作者：
Nadkarni, SK;Boughner, D;Fenster, A
通讯作者：
Fenster, A