The composition and morphology of the atherosclerotic lesion are currently considered more important determinants of acute coronary ischemic syndromes than the degree of stenosis. When a lesion is unstable, it may rupture and cause an acute thrombotic reaction. A rupture prone plaque contains a large lipid pool covered by a thin fibrous cap. The stress in the cap increases with decreasing thickness. Additionally, it may be weakened by macrophage infiltration. Intravascular ultrasound (IVUS) elastography might be an ideal technique to assess the presence of lipid pools and identify high stress regions.
Get full access to this article
View all access options for this article.
References
1.
MintzGSNissenSEAndersonWD. ACC Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology2001; 37: 1478–92.
2.
PratiFArbustiniELabellarteA. Correlation between high frequency intravascular ultrasound and histomorphology in human coronary arteries. Heart2001; 85: 567–570.
3.
KomiyamaNBerryGKolzM. Tissue characterization of atherosclerotic plaques by intravascular ultrasound radiofrequency signal analysis: An in vitro study of human coronary arteriesAmerican Heart Journal2000; 140: 565–574.
4.
HiroTFujiiTYasumotoK. Detection of Fibrous Cap in Atherosclerotic Plaque by Intravascular Ultrasound by Use of Color Mapping of Angle-Dependent Echo-Intensity VariationCirculation2001; 103: 1206–1211.
FusterVSteinBAmbroseJ. Atherosclerotic plaque rupture and thrombosis. Evolving conceptsCirculation1990; 82: II.47–II.59.
7.
MorenoPRFalkEPalaciosIF. Macrophage infiltration in acute coronary syndromes: implcations for plaque rupture. Circulation1994; 90: 775–778.
8.
LoreeHMTobiasBJGibsonLJ. Mechanical properties of model atherosclerotic lesion lipid poolsArteriosclerosis and Thrombosis1994; 14: 230–234.
9.
LoreeHMGrodzinskyAJParkSYGibsonLJLeeRT. Static circumferential tangential modulus of human atherosclerotic tissueJournal of Biomechanics1994; 27: 195–204.
10.
LeeRTRichardsonGLoreeHM. Prediction of mechanical properties of human atherosclerotic tissue by high-frequency intravascular ultrasound imagingArteriosclerosis and Thrombosis1992; 12: 1–5.
11.
LendonCLDaviesMJBornGVRRichardsonPD. Atherosclerotic plaque caps are locally weakened when macrophage density is increased. Atherosclerosis1991; 87: 87–90.
12.
LoreeHMKammRDStringfellowRGLeeRT. Effects of fibrous cap thickness on peak circumferential stress in model atherosclerotic vessels. Circulation Research1992; 71: 850–858.
13.
RichardsonPDDaviesMJBornGVR. Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet1989; 21: 941–944.
14.
OphirJCéspedesElPonnekantiHYazdiYLiX. Elastography: a method for imaging the elasticity in biological tissues. Ultrasonic Imaging1991; 13: 111–134.
15.
CéspedesElOphirJPonnekantiHMakladN. Elastography: elasticity imaging using ultrasound with application to muscle and breast in vivoUltrasonic Imaging1993; 17: 73–88.
16.
CéspedesElHuangYOphirJSprattS. Methods for estimation of subsample time delays of digitized echo signals. Ultrasonic Imaging1995; 17: 142–171.
17.
SarvazyanAPEmelianovSYSkovoradaAR.Intracavity device for elasticity imaging, US patent, 1993.
18.
TalhamiHEWilsonLSNealeML. Spectral tissue strain: a new technique for imaging tissue strain using intravascular ultrasound. Ultrasound in Medicine and Biology1994; 20: 759–772.
19.
RyanLKFosterFS. Ultrasonic measurement of differential displacement and strain in a vascular model. Ultrasonic imaging1997; 19: 19–38.
20.
VargheseTOphirJ. Characterization of elastographic noise using the envelope of echo signals. Ultrasound in Medicine and Biology1998; 24: 543–55.
21.
ShapoBMCroweJRErkampR. Strain imaging of coronary arteries with intraluminal ultrasound: experiments on an inhomogeneous phantom. Ultrasonic Imaging1996; 18: 173–191.
22.
ShapoBMCroweJRSkovorodaAR. Displacement and strain imaging of coronary arteries with intraluminal ultrasound IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control1996; 43: 234–246.
23.
ChoiCDSkovorodaAEmelianovSO'DonnellM.Strain imaging of vascular pathologies using a compliant balloon catheter. IEEE Ultrasonics Symposium, Puerto Rico. US.
24.
ChoiCDSkovorodaAREmelianovSYO'DonnellM. An integrated compliant balloon ultrasound catheter for intravascular strain imaging. IEEE Trans Ultrason Ferroelectr Freq Control200249 (11):1552–60.
25.
de KorteCLCéspedesElvan der SteenAFWPasterkampGBomN. Intravascular ultrasound elastography: Assessment and imaging of elastic properties of diseased arteries and vulnerable plaqueEuropean Journal of Ultrasound1998; 7: 219–224.
26.
de KorteCLvan der SteenACéspedesEl. Characterisation of plaque components and vulnerability with intravascular ultrasound elastographyPhysics in Medicine and biology2000, 45: 1465–1475.
27.
DoyleyMMMastikFde KorteCL. Advancing intravascular ultrasonic palpation towards clinical applications. Ultrasound in Medicine and Biology2001; 27: 1471–1480.
28.
DoyleyMMde KorteCLMastikFCarlierSvan der SteenAFW. Advancing intravascular palpography towards clinical applications, Acoustical Imaging, Bristol, 2000Vol.25Plenum Press, New York, NY USA.
29.
CéspedesElde KorteCLvan der SteenAFW. Intraluminal ultrasonic palpation assessment of local and cross-sectional tissue stiffness. Ultrasound in Medicine and Biology2000; 26: 385–396.
30.
de KorteCLCéspedesElvan der SteenAFWLancéeCT. Intravascular elasticity imaging using ultrasound: feasibility studies in phantoms. Ultrasound in Medicine and Biology1997; 23: 735–746.
31.
de KorteCLCarlierSGMastikF.Intracoronary elastography in the catheterisation laboratory: preliminary patient results, IEEE Ultrasonics Symposium. Lake Tahoe. CA, USA, 1999.
32.
AlamSOphirJKonofagouE. An adaptive strain estimator for elastographyIEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control1998; 45: 461–472.
33.
BrusseauEPerreyCDelachartreP. Axial strain imaging using a local estimation of the scaling factor from RF ultrasound signals. Ultrasonic Imaging2000; 22: 95–107.
34.
BrusseauEFromageauJFinetGDelachartrePVrayD. Axial strain imaging of intravascular data: results on polyvinyl alcohol cryogel phantoms and carotid arteryUltrasound in Medicine and Biology2001: in press.
35.
de KorteCLPasterkampGvan der SteenAFWWoutmanHABomN. Characterization of plaque components using intravascular ultrasound elastography in human femoral and coronary arteries in vitro. Circulation2000; 102: 617–623.
36.
Van der SteenAFWMastikFDe KorteCLSchaarJA.Method and divice lor generating 3D images with hardness information. Dutch patent application P56781NL00.
37.
de KorteCLSierevogelMMastikF. Identification of Atherosclerotic Plaque Components with Intravascular Ultrasound Elastography in vivo: a Yucatan pig studyCirculation2002; 105: 1627–1630.
38.
de KorteCLCarlierSGMastikF. Morphological and mechanical information of coronary arteries obtained with Intravascular elastography: a feasibility study in vivoEuropean Heart Journal2002; 23: 405–413.
39.
de KorteCLDoyleyMMCarlierSG.High resolution IVUS elastography in patients. IEEE Ultrasonics Symposium, Puerto Rico, USA, 2000.
40.
Van der SteenAFWDe KorteCLCéspedesEl. Intravascular ultrasound elastographyUltraschall Med1998; 19: 196–201.
41.
Van der SteenAFWCéspedesElDe KorteCLCarlierSGLiWMastikFLanceeCTEbeleMSerruysFWBomN. Novel developments in intravascular imaging. IEEE Ultrasonics Symposium, Sendai, Japan1998: 1733–1742.
42.
Van der SteenAFWDe KorteCLMastikFDoyleyMMCarlierSGLupottiFACespedesElSerruysPWBomN. Recent development in IVUS. BMUS Bulletin2000; 8: 24–27.
43.
SchaarJAde KorteCLMastikFStrijderCPasterkampGSerruysPWvan der SteenAFW. Vulnerable Plaque Characterization With Intravascular ElastographyJACC39, Suppl A, 1054–20, 2002.
44.
SchaarJAde KorteCLMastikFStrijderCPasterkampGvan der SteenAFW. Vulnerable Plaque Detection with Intravascular Elastography: A Sensitivity and Specificity StudyCirculation104, Suppl 2176.2001.
45.
SchaarJAMastikFde KorteCLDoyleyMMCarlierSBomNSerruysPWvan der SteenAFW. Three-dimensional palpography a new tool for detection of vulnerable plaque, a feasibility and reproducibility in vitro. Eur Heart J2001; 22.Suppl. Sep:2784.
