Ultrasonic characterization of atherosclerotic plaque using multiple scattering

摘要 动脉粥样硬化是西方国家发病率和死亡率的主要原因，在 很大一部分是由于斑块破裂。易损斑块是最容易破裂的，是主要的 急性心肌梗死和心脏性猝死的原因。动脉的新生血管 外膜血管壁似乎参与了动脉粥样硬化的进展和 动脉粥样硬化斑块新生血管是最强的预测因子之一。 未来的心血管事件。目前还没有技术可用于定量 评估脆弱斑块，这仍然是一个未得到满足的需求。 微泡是一种非常强大的造影剂，用于超声成像 血管系统和对比增强血管内超声(CE-IVUS)似乎是 最有希望检测动脉粥样硬化和易损斑块的成像方法。 然而，尽管该技术允许检测血管，但目前CE-IVUS 没有提供其微体系结构的量化特征。CE-2的特异性 静脉内超声需要改进。 对活体血管网络的定量评估将有力地预测 心血管事件目前还没有这样的技术存在。我们建议使用超声波 多重散射以表征新生血管网络的微结构特性。通过 使用超声多重散射来表征新生血管的结构，我们 将为CE-IVUS增添一个新的维度。使用我们在这里建议开发的技术，CE-IVUS 将不仅用于检测斑块相关的新生血管生成，而且还用于其 定量表征。这将极大地提高CE-IVUS对 斑块易损性评估。最终，它将使血管的超声评估成为可能 血管将成为临床广泛使用的筛查、诊断和监测斑块的工具 脆弱性。

ABSTRACT Atherosclerosis is the leading cause of morbidity and mortality in Western countries, in large part due to plaque rupture. Vulnerable plaques are the most likely to rupture, being the major cause of acute myocardial infarction and sudden cardiac death. Neovascularization of the arterial walls by adventitial vasa vasorum appears to participate in the progression of atherosclerosis and atherosclerotic plaque neovascularization was shown to be one of the strongest predictors of future cardiovascular events. No techniques are currently available for the quantitative assessment of vulnerable plaque, which remains an unmet need. Microbubbles are extremely powerful contrast agents for ultrasonic imaging of the vasculature and Contrast Enhanced IntraVascular UltraSound (CE-IVUS) seems to be one of the most promising imaging modalities for the detection of atherosclerosis and vulnerable plaque. However, although this technique allows the detection of the vasa vasorum, CE-IVUS currently does not provide a quantitative characterization of its micro-architecture. The specificity of CE- IVUS needs to be improved. A quantitative assessment of the vasa vasorum network in vivo would strongly predict cardiovascular events yet no such techniques currently exist. We propose using ultrasound multiple scattering to characterize the microstructural properties of neovascular networks. By using ultrasound multiple scattering to characterize the architecture of the neovascularization, we will add a new dimension to CE-IVUS. With the technique we propose to develop here, CE-IVUS will not only be used for the detection of plaque related neo-angiogenesis, but also for its quantitative characterization. This will dramatically increase the specificity of CE-IVUS for the assessment of plaque vulnerability. Ultimately, it will enable the ultrasonic assessment of the vasa vasorum to become a widely used clinical tool for screening, diagnosis and monitoring of plaque vulnerability.