ANR - Toward a novel powerful technique to detect in vivo human vulnerable atherosclerotic plaques: a synergic approach combining elastography and modulography methods

心血管疾病仍然是发达国家的头号杀手。急性冠状动脉综合征和/或心脏性猝死都是由易受伤害的冠状动脉粥样硬化斑块破裂引起的。此外，中风似乎是第三大致死原因，也是致病的首要原因。超过60%的脑梗塞是由易损斑块破裂引起的。在此背景下，我们建议法国/加拿大多学科联盟(MELANII)开发基于超声(US)的新成像工具，分别评估易受攻击的冠状动脉和颈动脉壁的机械稳定性。这项研究是及时的，因为现在已经确定，在通常是致命的血栓形成事件的起始处，机械应力影响着几个细胞过程，包括斑块内巨噬细胞的迁移、管壁重构和斑块血管生成的调节，这些都是斑块脆弱性状态的核心。参与这项拨款申请的加拿大科学家开发了健壮的弹性成像方法(EVE和NIVE)并申请了专利，以与美国一起估计血管壁内的变形。与此同时，法国合作伙伴设计并申请了一项补充成像调制工具(IMOD)的专利，通过突出所有斑块成分的弹性(模数图)更进一步。在法国和加拿大都找不到这样一种血管弹性成像和调制成像的综合专业知识。这项为期3年的MELANII法国/加拿大资助计划(Blanc International)的主要目标是：1)结合法国的IMOD算法的性能，设计一种新型的半自动“弹性成像/模块成像/形态学”工具

Cardiovascular disease remains the number one killer in developed countries. Acute coronary syndromes and/or sudden cardiac death are both caused by the rupture of a vulnerable coronary atherosclerotic plaque. In addition, stroke appears to be the third cause of death and the leading cause of morbidity. More than 60% of all cerebral infarctions are caused by the rupture of a vulnerable plaque. In this context, we are proposing a French / Canadian pluridisciplinary consortium (MELANII) to develop new ultrasound (US) based imaging tools to assess the mechanical stability of vulnerable coronary and carotid artery walls, respectively. This research is timely since it is now established that mechanical stress affects several cellular processes at the origin of an often fatal thrombotic event, including macrophage migration within the plaque, vessel wall remodelling and modulation of plaque angiogenesis, which are central to the plaque's vulnerability status. Canadian scientists involved in this grant application developed and patented robust elastography approaches (EVE and NIVE) to estimate, with US, deformations within the vascular wall. Concomitantly, French partners designed and patented a complementary imaging modulography tool (iMOD) to go one step further by highlighting the elasticity of all plaque constituents (modulogram). Such a combined expertise in vascular elastography and modulography cannot be found in either France or Canada. The main objectives of this 3-year MELANII France/Canada grant (programme BLANC international) are: 1) to design a novel semi-automatic "elastography /modulography/morphology" tool combining the performances of the French's iMOD algorithm