SlideShare ist ein Scribd-Unternehmen logo
1 von 11
Editorial Slides
VP Watch, April 10, 2002, Volume 2, Issue 14
Elastography; An Add-On to Your IVUS for
Detection of Vulnerable Plaque?
The composition of atherosclerotic plaque is a
major determinant of its vulnerability to rupture.
Soft plaques with large lipid core and thin fibrous
cap are more vulnerable to rupture.
Intravascular elastography is measuring local
elastic properties (stiffness) of vessel wall using
IVUS.1
The technique is able to discriminate
between soft and hard materials. 2
 The principle is that soft material will strain
more compared with hard material when a force
is applied on the tissue. 1
For example plaques
with large lipid core strain differently from highly
calcified plaques. 3
 Elastography has been clinically used in
other fields such as breast cancer and prostate
cancer. 4
 Fibrous tissue has lower strain values than
fibro-fatty tissue, and the latter one has
lower strain levels than fatty tissue.
Identification of these 3 tissue types on the
basis of their echogenesity (IVUS) is not
possible. 2
 In an earlier ex vivo study De Korte and his
colleagues showed different mean strain
values in fibrous, fibro-fatty, and fatty
atherosclerotic plaques in human coronary
and femoral arteries. 2
 As reported in this issue of VPWatch,
de Korte, Schaar, van der Steen, and their
colleagues showed that IVUS elastography is
feasible in vivo in an atherosclerotic pig
model.5
 They showed that Elastography has a high
sensitivity to identify fatty material.5
Echogram and Elastogram Obtained in vivo
in Yucatan Pig Coronary
Elastic-von Giesson Picro-Sirius red
Polarized light
Acid Phosphatase
De korte et al.; Circulation 105 (14): 1627-1630 (2002)
In this study de Korte and colleagues
found the sensitivity of 100% with a
corresponding specificity of 80% to
identify fatty plaques for a strain value
of 0.35%. 5
They also showed high-strain spot has
75% sensitivity and 100% specificity to
identify lipid. A 92% sensitivity and
92% specificity was found to identify
the presence of macrophages. 5
Conclusion
• In vivo coronary elastography using IVUS
catheter is feasible.
• IVUS elastography is able to determine
plaques with large lipid core from fibrous
rich plaques.
Questions:
• IVUS elastography at best can identify
lipid rich plaques from fibrotic plaques.
The question is how elastography can
directly detect plaque inflammation?
• What are the normal and abnormal values
to use elastography for making clinical
decision?
Questions:
• Do plaques with positive (expansive)
remodeling exhibit higher strain comparing
to plaques with negative (constrictive)
remodeling, regardless of plaque
components?
References
1) Ophir J, Céspedes EI, Ponnekanti H, et al. Elastography: a method for imaging the
elasticity in biological tissues. Ultrason Imaging. 1991;13:111–134.
2) de Korte CL, van der Steen AF, Cepedes EI, Pasterkamp G, Carlier SG, Mastik F,
Schoneveld AH, Serruys PW, Bom N; Characterization of plaque components and
vulnerability with intravascular ultrasound elastography.
Phys Med Biol. 2000 Jun;45(6):1465-75.
3) van der Steen AF, de Korte CL, Cespedes EI.; Intravascular ultrasound
elastography.Ultraschall Med.
4) Hiltawsky KM, Kruger M, Starke C, Heuser L, Ermert H, Jensen A.Freehand
ultrasound elastography of breast lesions: clinical results. Ultrasound Med Biol. 2001
Nov;27(11):1461-9.
5) Chris L. de Korte, Marion J. Sierevogel, Frits Mastik, Chaylendra Strijder, Johannes
A. Schaar, Evelyn Velema, Gerard Pasterkamp, P.W. Serruys, and Anton F.W. van
der Steen; Identification of Atherosclerotic Plaque Components With Intravascular
Ultrasound Elastography In Vivo: A Yucatan Pig Study Circulation 2002 105: 1627 -
1630

Weitere ähnliche Inhalte

Was ist angesagt?

刊2013Q405-CYTOO專刊(確定版)
刊2013Q405-CYTOO專刊(確定版)刊2013Q405-CYTOO專刊(確定版)
刊2013Q405-CYTOO專刊(確定版)
Shelly Shen
 

Was ist angesagt? (8)

刊2013Q405-CYTOO專刊(確定版)
刊2013Q405-CYTOO專刊(確定版)刊2013Q405-CYTOO專刊(確定版)
刊2013Q405-CYTOO專刊(確定版)
 
Short case...brain stem glioma
Short case...brain stem gliomaShort case...brain stem glioma
Short case...brain stem glioma
 
Application Note: Angiogenesis
Application Note: AngiogenesisApplication Note: Angiogenesis
Application Note: Angiogenesis
 
Control of Cancer Stem Cell Migration and invasion
Control of Cancer Stem Cell Migration and invasionControl of Cancer Stem Cell Migration and invasion
Control of Cancer Stem Cell Migration and invasion
 
Central neurocytoma-case report
Central neurocytoma-case reportCentral neurocytoma-case report
Central neurocytoma-case report
 
Cancer stem cell dr.neelam ahirwar
Cancer stem cell dr.neelam ahirwarCancer stem cell dr.neelam ahirwar
Cancer stem cell dr.neelam ahirwar
 
Diagnostik neoplasma
Diagnostik neoplasmaDiagnostik neoplasma
Diagnostik neoplasma
 
CANCER STEM CELLS
CANCER STEM CELLSCANCER STEM CELLS
CANCER STEM CELLS
 

Andere mochten auch

053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaques053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaques
SHAPE Society
 

Andere mochten auch (20)

Existing intravascular imaging technology for plaque characterization
Existing intravascular imaging technology for plaque characterizationExisting intravascular imaging technology for plaque characterization
Existing intravascular imaging technology for plaque characterization
 
L box contemporary non-invasive cardiology testing
L  box   contemporary non-invasive cardiology testingL  box   contemporary non-invasive cardiology testing
L box contemporary non-invasive cardiology testing
 
Rumberger 2nd vp symposium 3 6 04
Rumberger 2nd vp symposium 3 6 04Rumberger 2nd vp symposium 3 6 04
Rumberger 2nd vp symposium 3 6 04
 
Corporate Presentation July 2016
Corporate Presentation July 2016Corporate Presentation July 2016
Corporate Presentation July 2016
 
Lecture vienna september 16 2005
Lecture vienna september 16 2005Lecture vienna september 16 2005
Lecture vienna september 16 2005
 
Editorial v2n7
Editorial v2n7Editorial v2n7
Editorial v2n7
 
Ischemic heart diseases 2
Ischemic heart diseases 2Ischemic heart diseases 2
Ischemic heart diseases 2
 
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin Zulfiqar
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin ZulfiqarRole of mdct angio in management of acute chest pain Dr. Muhammad Bin Zulfiqar
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin Zulfiqar
 
Spect ct -dan berman
Spect ct -dan bermanSpect ct -dan berman
Spect ct -dan berman
 
Myocardial Infraction diagnosis using CT-Scan & MRI
Myocardial Infraction diagnosis using CT-Scan & MRIMyocardial Infraction diagnosis using CT-Scan & MRI
Myocardial Infraction diagnosis using CT-Scan & MRI
 
Role of MDCT tin coronary artery part 6 (limitation pitfalls artifacts) Dr Ah...
Role of MDCT tin coronary artery part 6 (limitation pitfalls artifacts) Dr Ah...Role of MDCT tin coronary artery part 6 (limitation pitfalls artifacts) Dr Ah...
Role of MDCT tin coronary artery part 6 (limitation pitfalls artifacts) Dr Ah...
 
Role of nuclear medicine
Role of nuclear medicineRole of nuclear medicine
Role of nuclear medicine
 
Cardiac ct ccta
Cardiac ct cctaCardiac ct ccta
Cardiac ct ccta
 
Nuclear Imaging In Cardiology Cme
Nuclear Imaging In Cardiology CmeNuclear Imaging In Cardiology Cme
Nuclear Imaging In Cardiology Cme
 
Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...
Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...
Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...
 
Advanced Diagnostic Center (radiology): An Introduction-DIAGNOSTIC RADIOLOGY ...
Advanced Diagnostic Center (radiology): An Introduction-DIAGNOSTIC RADIOLOGY ...Advanced Diagnostic Center (radiology): An Introduction-DIAGNOSTIC RADIOLOGY ...
Advanced Diagnostic Center (radiology): An Introduction-DIAGNOSTIC RADIOLOGY ...
 
Cardiac MRI
Cardiac MRICardiac MRI
Cardiac MRI
 
Coronary CT
Coronary CTCoronary CT
Coronary CT
 
511 first steps towards understanding
511 first steps towards understanding511 first steps towards understanding
511 first steps towards understanding
 
053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaques053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaques
 

Ähnlich wie 216 elastography using ivus

Acs0308 Soft Tissue Sarcoma
Acs0308 Soft Tissue SarcomaAcs0308 Soft Tissue Sarcoma
Acs0308 Soft Tissue Sarcoma
medbookonline
 

Ähnlich wie 216 elastography using ivus (20)

Elastofibroma: A Soft Tissue Infiltrative Lesion Revealing the Importance of ...
Elastofibroma: A Soft Tissue Infiltrative Lesion Revealing the Importance of ...Elastofibroma: A Soft Tissue Infiltrative Lesion Revealing the Importance of ...
Elastofibroma: A Soft Tissue Infiltrative Lesion Revealing the Importance of ...
 
Thermo elastography
Thermo elastographyThermo elastography
Thermo elastography
 
043 thermo elastography
043 thermo elastography043 thermo elastography
043 thermo elastography
 
043 thermo elastography
043 thermo elastography043 thermo elastography
043 thermo elastography
 
Tumors around knee
Tumors around kneeTumors around knee
Tumors around knee
 
Imaging of Soft tissue pathology
Imaging of Soft tissue pathologyImaging of Soft tissue pathology
Imaging of Soft tissue pathology
 
eus-200527113847.pdf
eus-200527113847.pdfeus-200527113847.pdf
eus-200527113847.pdf
 
ENDOSCOPIC ULTRASOUND
ENDOSCOPIC ULTRASOUNDENDOSCOPIC ULTRASOUND
ENDOSCOPIC ULTRASOUND
 
Extra skeletal Ewing’s Sarcoma
Extra skeletal Ewing’s SarcomaExtra skeletal Ewing’s Sarcoma
Extra skeletal Ewing’s Sarcoma
 
Diagnostic Ultrasound soft tissue
Diagnostic Ultrasound soft tissueDiagnostic Ultrasound soft tissue
Diagnostic Ultrasound soft tissue
 
059 can oct catheter see plaque macrophages
059 can oct catheter see plaque macrophages059 can oct catheter see plaque macrophages
059 can oct catheter see plaque macrophages
 
Esv3n2
Esv3n2Esv3n2
Esv3n2
 
059 can oct catheter see plaque macrophages
059 can oct catheter see plaque macrophages059 can oct catheter see plaque macrophages
059 can oct catheter see plaque macrophages
 
Acs0308 Soft Tissue Sarcoma
Acs0308 Soft Tissue SarcomaAcs0308 Soft Tissue Sarcoma
Acs0308 Soft Tissue Sarcoma
 
Flaps in ortho.pdf
Flaps in ortho.pdfFlaps in ortho.pdf
Flaps in ortho.pdf
 
J ENDOVASC THER 2007;14:176–183 Clinical Investigation
J ENDOVASC THER 2007;14:176–183 Clinical InvestigationJ ENDOVASC THER 2007;14:176–183 Clinical Investigation
J ENDOVASC THER 2007;14:176–183 Clinical Investigation
 
Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...
Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...
Comparative Study Of Pterygium Excision With Conjunctival Autograft,Wet Amnio...
 
Impact of dead space closure and lymph vessel ligation during MRM on Post-ope...
Impact of dead space closure and lymph vessel ligation during MRM on Post-ope...Impact of dead space closure and lymph vessel ligation during MRM on Post-ope...
Impact of dead space closure and lymph vessel ligation during MRM on Post-ope...
 
Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...
Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...
Squamous Cell Carcinoma in the Native Kidney of a Renal Transplant Recipient ...
 
Pancreaticobiliary Endoscopic Ultrasound (EUS)
Pancreaticobiliary Endoscopic Ultrasound (EUS) Pancreaticobiliary Endoscopic Ultrasound (EUS)
Pancreaticobiliary Endoscopic Ultrasound (EUS)
 

Mehr von SHAPE Society (20)

Barth imt
Barth imtBarth imt
Barth imt
 
Braunwald
BraunwaldBraunwald
Braunwald
 
Acc vp-org 3-02 stone
Acc vp-org 3-02 stoneAcc vp-org 3-02 stone
Acc vp-org 3-02 stone
 
101205 shape aha 2005 f
101205 shape aha 2005 f101205 shape aha 2005 f
101205 shape aha 2005 f
 
Acc v porg becker
Acc v porg beckerAcc v porg becker
Acc v porg becker
 
Acc 2005-1, v pl-vp
Acc 2005-1, v pl-vpAcc 2005-1, v pl-vp
Acc 2005-1, v pl-vp
 
Acc presentation macrophage (1)
Acc presentation macrophage (1)Acc presentation macrophage (1)
Acc presentation macrophage (1)
 
Acc v porg
Acc v porgAcc v porg
Acc v porg
 
Acc presentation (1)
Acc presentation (1)Acc presentation (1)
Acc presentation (1)
 
Ac cculprit
Ac cculpritAc cculprit
Ac cculprit
 
Acc presentation lipid coated(2)
Acc presentation lipid coated(2)Acc presentation lipid coated(2)
Acc presentation lipid coated(2)
 
Acc 2002 microarray mehran for print
Acc 2002 microarray mehran for printAcc 2002 microarray mehran for print
Acc 2002 microarray mehran for print
 
Acc booth inventory
Acc booth inventoryAcc booth inventory
Acc booth inventory
 
Acc 04 vuln pt
Acc 04 vuln ptAcc 04 vuln pt
Acc 04 vuln pt
 
Acc 2002 mehran for print
Acc 2002  mehran for printAcc 2002  mehran for print
Acc 2002 mehran for print
 
Acc2002 thermography
Acc2002 thermographyAcc2002 thermography
Acc2002 thermography
 
A20 gene
A20 geneA20 gene
A20 gene
 
#1 killer of human beings in the 21st century
#1 killer of human beings in the 21st century#1 killer of human beings in the 21st century
#1 killer of human beings in the 21st century
 
A20 is an atherosclerosis
A20 is an atherosclerosisA20 is an atherosclerosis
A20 is an atherosclerosis
 
103100
103100103100
103100
 

Kürzlich hochgeladen

💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
Sheetaleventcompany
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 

Kürzlich hochgeladen (20)

Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
Call Girls Service Jaipur {8445551418} ❤️VVIP BHAWNA Call Girl in Jaipur Raja...
 
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 8250077686 Top Class Call Girl Service Available
 
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
Coimbatore Call Girls in Thudiyalur : 7427069034 High Profile Model Escorts |...
 
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Amritsar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Amritsar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Amritsar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Amritsar Just Call 8250077686 Top Class Call Girl Service Available
 
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
Top Rated Pune Call Girls (DIPAL) ⟟ 8250077686 ⟟ Call Me For Genuine Sex Serv...
 
Top Rated Call Girls Kerala ☎ 8250092165👄 Delivery in 20 Mins Near Me
Top Rated Call Girls Kerala ☎ 8250092165👄 Delivery in 20 Mins Near MeTop Rated Call Girls Kerala ☎ 8250092165👄 Delivery in 20 Mins Near Me
Top Rated Call Girls Kerala ☎ 8250092165👄 Delivery in 20 Mins Near Me
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
 

216 elastography using ivus

  • 1. Editorial Slides VP Watch, April 10, 2002, Volume 2, Issue 14 Elastography; An Add-On to Your IVUS for Detection of Vulnerable Plaque?
  • 2. The composition of atherosclerotic plaque is a major determinant of its vulnerability to rupture. Soft plaques with large lipid core and thin fibrous cap are more vulnerable to rupture. Intravascular elastography is measuring local elastic properties (stiffness) of vessel wall using IVUS.1 The technique is able to discriminate between soft and hard materials. 2
  • 3.  The principle is that soft material will strain more compared with hard material when a force is applied on the tissue. 1 For example plaques with large lipid core strain differently from highly calcified plaques. 3  Elastography has been clinically used in other fields such as breast cancer and prostate cancer. 4
  • 4.  Fibrous tissue has lower strain values than fibro-fatty tissue, and the latter one has lower strain levels than fatty tissue. Identification of these 3 tissue types on the basis of their echogenesity (IVUS) is not possible. 2  In an earlier ex vivo study De Korte and his colleagues showed different mean strain values in fibrous, fibro-fatty, and fatty atherosclerotic plaques in human coronary and femoral arteries. 2
  • 5.  As reported in this issue of VPWatch, de Korte, Schaar, van der Steen, and their colleagues showed that IVUS elastography is feasible in vivo in an atherosclerotic pig model.5  They showed that Elastography has a high sensitivity to identify fatty material.5
  • 6. Echogram and Elastogram Obtained in vivo in Yucatan Pig Coronary Elastic-von Giesson Picro-Sirius red Polarized light Acid Phosphatase De korte et al.; Circulation 105 (14): 1627-1630 (2002)
  • 7. In this study de Korte and colleagues found the sensitivity of 100% with a corresponding specificity of 80% to identify fatty plaques for a strain value of 0.35%. 5 They also showed high-strain spot has 75% sensitivity and 100% specificity to identify lipid. A 92% sensitivity and 92% specificity was found to identify the presence of macrophages. 5
  • 8. Conclusion • In vivo coronary elastography using IVUS catheter is feasible. • IVUS elastography is able to determine plaques with large lipid core from fibrous rich plaques.
  • 9. Questions: • IVUS elastography at best can identify lipid rich plaques from fibrotic plaques. The question is how elastography can directly detect plaque inflammation? • What are the normal and abnormal values to use elastography for making clinical decision?
  • 10. Questions: • Do plaques with positive (expansive) remodeling exhibit higher strain comparing to plaques with negative (constrictive) remodeling, regardless of plaque components?
  • 11. References 1) Ophir J, Céspedes EI, Ponnekanti H, et al. Elastography: a method for imaging the elasticity in biological tissues. Ultrason Imaging. 1991;13:111–134. 2) de Korte CL, van der Steen AF, Cepedes EI, Pasterkamp G, Carlier SG, Mastik F, Schoneveld AH, Serruys PW, Bom N; Characterization of plaque components and vulnerability with intravascular ultrasound elastography. Phys Med Biol. 2000 Jun;45(6):1465-75. 3) van der Steen AF, de Korte CL, Cespedes EI.; Intravascular ultrasound elastography.Ultraschall Med. 4) Hiltawsky KM, Kruger M, Starke C, Heuser L, Ermert H, Jensen A.Freehand ultrasound elastography of breast lesions: clinical results. Ultrasound Med Biol. 2001 Nov;27(11):1461-9. 5) Chris L. de Korte, Marion J. Sierevogel, Frits Mastik, Chaylendra Strijder, Johannes A. Schaar, Evelyn Velema, Gerard Pasterkamp, P.W. Serruys, and Anton F.W. van der Steen; Identification of Atherosclerotic Plaque Components With Intravascular Ultrasound Elastography In Vivo: A Yucatan Pig Study Circulation 2002 105: 1627 - 1630