Ultrasonic characterization of atherosclerotic plaque using multiple scattering

摘要 在西方国家，动脉粥样硬化是发病率和死亡率的主要原因， 大部分是由于斑块破裂。易损斑块最有可能破裂， 急性心肌梗死和心源性猝死的原因。动脉新生血管 血管外膜血管壁似乎参与动脉粥样硬化的进展， 动脉粥样硬化斑块新血管形成被证明是最强的预测因子之一， 未来的心血管事件目前没有技术可用于定量分析。 评估易损斑块，这仍然是一个未满足的需求。 微泡是用于超声成像的非常强大的造影剂， 血管和造影剂增强血管内超声（CE-IVUS）似乎是一种 最有前途的成像方式检测动脉粥样硬化和易损斑块。 然而，尽管该技术允许检测血管，但CE-IVUS目前 没有提供其微结构的定量表征。CE的特异性- IVUS需要改进。 对体内血管网的定量评估将有力地预测 心血管事件，但目前还不存在这样的技术。我们建议使用超声波 多重散射来表征新生血管网络的微观结构特性。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增加一个新的维度。通过我们在这里提出的技术，CE-IVUS 将不仅用于检测斑块相关的新血管生成，而且用于其 定量表征这将大大提高CE-IVUS对 斑块易损性评估。最终，它将使超声波评估的血管 vasorum成为一种广泛应用于斑块筛查、诊断和监测的临床工具 易损性.

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.