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At least 19 recordsLinked to original sources

Optimizing the beam pattern of a forward-viewing ring-annular ultrasound array for intravascular imaging.

Intravascular ultrasound (IVUS) imaging systems using circumferential arrays mounted on cardiac catheter tips fire beams orthogonal to the principal axis of the catheter. The system produces high resolution cross-sectional images but must be guided by conventional angioscopy. A real-time forward-viewing array, integrated into the same catheter, could greatly reduce radiation exposure by decreasing angiographic guidance. Unfortunately, the mounting requirement of a catheter guide wire prohibits a full-disk imaging aperture. Given only an annulus of array elements, prior theoretical investigations have only considered a circular ring of point transceivers and focusing strategies using all elements in the highly dense array, both impractical assumptions. In this paper, we consider a practical array geometry and signal processing architecture for a forward-viewing IVUS system. Our specific design uses a total of 210 transceiver firings with synthetic reconstruction for a given 3-D image frame. Simulation results demonstrate this design can achieve side-lobes under -40 dB for on-axis situations and under -30 dB for steering to the edge of a 80 degrees cone.

Blood Vessels↗

Imaging of atherosclerosis. Intravascular imaging of the vulnerable atherosclerotic plaque: spotlight on temperature measurement.

The vulnerable atherosclerotic plaque is associated with an increased number of acute coronary syndromes. Current techniques such as coronary angiography are unable to detect and prospectively evaluate these lesions. Recently, other techniques, both invasive and noninvasive, are being developed trying to detect the plaque that is at increased risk for rupture eventually resulting in increased thrombosis. This review describes briefly evolving techniques for imaging of vulnerable plaques and describes in detail intravascular thermography.

Animals↗

Positron autoradiography for intravascular imaging: feasibility evaluation.

Approximately 70% of acute coronary artery disease is caused by unstable (vulnerable) plaques with an inflammation of the overlying cap and high lipid content. A rupturing of the inflamed cap of the plaque results in propagation of the thrombus into the lumen, blockage of the artery and acute ischaemic syndrome or sudden death. Morphological imaging such as angiography or intravascular ultrasound cannot determine inflammation status of the plaque. A radiotracer such as 18F-FDG is accumulated in vulnerable plaques due to higher metabolic activity of the inflamed cap and could be used to detect a vulnerable plaque. However, positron emission tomography (PET) cannot detect the FDG-labelled plaques because of respiratory and heart motions, small size and low activity of the plaques. Plaques can be detected using a miniature particle (positron) detector inserted into the artery. In this work, a new detector concept is investigated for intravascular imaging of the plaques. The detector consists of a storage phosphor tip bound to the end of an intravascular catheter. It can be inserted into an artery, absorb the 18F-FDG positrons from the plaques, withdrawn from the artery and read out. Length and diameter of the storage phosphor tip can be matched to the length and the diameter of the artery. Monte Carlo simulations and experimental evaluations of coronary plaque imaging with the proposed detector were performed. It was shown that the sensitivity of the storage phosphor detector to the positrons of 18F-FDG is sufficient to detect coronary plaques with 1 mm and 2 mm sizes and 590 Bq and 1180 Bq activities in the arteries with 2 mm and 3 mm diameters, respectively. An experimental study was performed using plastic tubes with 2 mm diameter filled with an FDG solution, which simulates blood. FDG spots simulating plaques were placed over the surface of the tube. A phosphor tip was inserted into the tube and imaged the plaques. Exposure time was 1 min in all simulations and experiments. Experiments showed that detecting the coronary plaques using the proposed technique is possible. The proposed technique has the potential for fast and accurate detection of vulnerable coronary and other intravascular plaques.

Autoradiography↗

Intravascular Imaging Methods for Venous Disorders.

The purposes are to assess the problems associated with intravascular imaging methods such as angioscopy and intravascular ultrasound (IVUS) and to evaluate their efficacy through the results of our observations. A total of 54 limbs in 53 patients, 50 patients with chronic venous insufficiency and 3 patients with deep vein thrombosis, were diagnosed and operated on using angioscopy (Olympus OES, order made type) and IVUS (Endosonics, model 82700). The imaging catheters were inserted through a branch of the long saphenous vein and the valves and the intraluminal views were observed. By angioscopy, intraluminal views were clearly observed in 98% of all lesions. However, observation became more difficult in iliac veins compared to in femoral and in long saphenous veins (p < 0.01). Venous wall and thrombus were detected more by IVUS than by angioscopy (p < 0.01), but only 21 valves (24%) were visualized by IVUS among the 88 valves observed by angioscopy. The intravascular imaging method of angioscopy is more suitable for observing valves and intraluminal views compared with IVUS, whereas IVUS is more suitable for observing the cross-sectional venous wall.

Journal Article↗

Balloon angioplasty of coarctation of the aorta evaluated with intravascular ultrasound imaging.

Intravascular ultrasound images were employed to evaluate aortic coarctation before and after balloon angioplasty. Measurements obtained with use of an ultrasound imaging catheter correlated well with measurements made with digital aortography, both in the area of coarctation and in areas proximal and distal to it. The intravascular ultrasound images dramatically revealed dissection of the aortic wall and an intimal flap that was not appreciated on cineaortography or digital subtraction angiography. Intravascular ultrasound imaging may yield important morphologic information unavailable by other imaging techniques. Such information may allow more precise definition of the results of intravascular procedures and improve understanding of lesion characteristics predictive of a successful outcome.

Adult↗

New developments in intravascular ultrasound imaging.

IntraVascular Ultrasound Imaging (IVUS) has already been proposed in the early days of diagnostic ultrasound. Today, it has come under further full attention as a result of minimal invasive techniques. Not only excellent intravascular two-dimensional (2D) images are presently obtained, also three-dimensional (3D) reconstructed images show their diagnostic value. Based on 3D information, quantitative data such as plaque volume can be calculated. The procedure includes automatic contour detection based on image segmentation methods and greatly speeds up clinical evaluation. With the use of additional X-ray information, the true tortuous vessel geometry can be reconstructed in 3D. This allows, by numerical modelling techniques, to calculate endothelial shear stress values, which in turn may indicate sites prone to stenosis. With a decorrelation technique for radiofrequency (RF) echo information from sequential data in the same beam direction and integration method over the entire cross section, blood velocity can be shown colour-coded during the cardiac cycle, while even blood flow quantification seems to be possible. In vitro as well as in vivo experiments have shown the feasibility of the method. Intravascular imaging can be used to study the biomechanical properties of atheroma components. Local radial strain, used as a measure of local tissue hardness, can be estimated to identify hard or soft plaques independently of the echogenicity contrast between plaque and vessel wall.

Blood Flow Velocity↗

[Acute coronary syndrome diagnosed by the intravascular imaging].

Coronary plaque rupture and the following formed thrombus have been revealed the cause of acute coronary syndrome. This evidence had been proposed by the pathologists 100 years ago; however, the intravascular imaging such as intravascular ultrasound (IVUS) or coronary angioscopy has revealed the clinical evidences in live human being. Thrombus and yellow plaque detected by coronary angioscopy as well as the ruptured fibrous cap detected by IVUS are the characteristics for the lesion of ACS, which does not show the significant stenosis. Thus, ACS lesion should be diagnosed by IVUS or coronary angioscopy.

Angina, Unstable↗

Scanning techniques for three-dimensional forward-viewing intravascular ultrasound imaging.

Intravascular ultrasound (US) imaging is a useful tool for assessing arterial disease and aiding treatment procedures. Forward-viewing intravascular US imaging could be of particular use in severely stenosed or totally occluded arteries, where the current side-viewing intravascular US systems are limited by their inability to access the site of interest. In this study, five 3-D forward-viewing intravascular scanning patterns were investigated. The work was carried out using scaled-up vessel phantoms constructed from tissue-mimicking material and a PC-controlled scanning and acquisition system. The scanning patterns were examined and evaluated with regard to the image quality of dense and sparse data sets, the accuracy of quantitative measurements of lumen dimensions and the potential for clinical use. The relative merits and drawbacks of the different patterns are discussed and a preferred scanning pattern is recommended.

Arterial Occlusive Diseases↗

In vitro high resolution intravascular imaging in muscular and elastic arteries.

High resolution (125-microns lateral, 55-microns axial) images of 16 muscular (femoral) and 15 elastic (common carotid) human arteries were made in vitro with use of a prototype 45-MHz intravascular imaging system. Four distinct regions of scattering, excluding plaque, were identified in the ultrasound images corresponding histologically to the adventitia, media, thickened intima and elastic laminae, both internal and external. Arterial samples imaged under pressure and in a collapsed state underwent dimensional changes but exhibited similar levels of backscatter amplitude. All the elastic arteries displayed a prominent echogenic media, whereas all the muscular arteries displayed an echolucent media. Scattering from the internal elastic lamina in muscular arteries provided an excellent landmark for defining the location and extent of intimal thickening or plaque. In elastic arteries the internal elastic lamina could not be distinguished from the echogenic media; consequently, the boundary between the media and intimal layer was indistinct. Differences in the relative concentration and organization of collagen and elastin were found to provide a consistent explanation for the differences in scattering that were observed between individual layers within an artery as well as between muscular and elastic arteries.

Arteriosclerosis↗

Tissue characterization in intravascular ultrasound images.

Intravascular ultrasound (IVUS) imaging permits direct visualization of vascular pathology. It has been used to evaluate lumen and plaque in coronary arteries and its clinical significance for guidance of coronary interventions is increasingly recognized. Conventional manual evaluation is tedious and time-consuming. This paper describes a highly automated approach to segmentation of coronary wall and plaque, and determination of plaque composition in individual IVUS images and pullback image sequences. The determined regions of plaque were classified in one of three classes: soft plaque, hard plaque, or hard plaque shadow. The method's performance was assessed in vitro and in vivo in comparison with observer-defined independent standards. In the analyzed images and image sequences, the mean border positioning error of the wall and plaque borders ranged from 0.13-0.17 mm. Plaque classification correctness was 90%.

Algorithms↗

Validation of Automated Border Detection in Intravascular Ultrasound Images.

Intravascular ultrasound (IVUS) imaging provides cross-sectional views of the vessel lumen; however, lumen measurements still rely on operator-dependent border delineation and time-consuming lumen tracings. We tested a new system for automated lumen border detection in IVUS images based on acoustic quantification of blood and vessel wall. In 10 rabbits, 29 segments of the aorta were imaged in vivo using a 2.9-Fr IVUS catheter. IVUS images were obtained during motorized pullbacks of aortic segments of 18 mm length. Automated measurements of lumen dimensions were compared to automated measurements of a second pullback through the same segment, lumen measurements derived from visual border tracings in IVUS images, and to quantitative angiography. The automated system showed good reproducibility: Correlations for repeated measurements of lumen area, maximal and minimal lumen diameters were r = 0.97, r = 0.91, and r = 0.93, respectively. Automated measurements also correlated well to visual image analysis (lumen area, r = 0.97; maximal lumen diameter, r = 0.89; minimal lumen diameter, r = 0.89) and to angiographic measurements (lumen area, r = 0.93; lumen diameter, r = 0.95). In 12% of the images, the automated system overestimated lumen dimensions because of weak wall signals in the presence of echolucent structures next to the wall. Signal artifacts from the IVUS catheter itself or strong blood backscatter resulted in lumen underestimation in 6% of the images. Over- and underestimation of lumen by the border detection system were often associated with eccentric catheter position. Thus, lumen measurements in vivo IVUS images can be performed using an automated border detection system based on acoustic quantification of blood and vessel wall. The system allows reproducible and accurate measurements of lumen area and diameters. (ECHOCARDIOGRAPHY, Volume 13, November 1996)

Journal Article↗

Evaluation of an automatic intraluminal edge detection technique for intravascular ultrasound images.

Intravascular ultrasound (IVUS) imaging enables detailed analysis and precise measurements of vascular cross-sections. However, to achieve a reduction in the existing level of observer variability requires the development of quantitative IVUS. We have developed a fully automatic intraluminal edge detection technique, based on adaptive active contour models and called ADDER (adaptive damping dependent on echographic regions) that allows the quantitation of the intraluminal cross-sectional area (ICSA). Using a 30-MHz mechanically rotated transducer mounted at the tip of a 3.5-F catheter, 58 normal and pathologic arterial segments (from coronary, renal, splenic, iliac, and carotid arteries) were imaged in vitro. These images were analyzed by 2 experts, E1 and E2, who manually traced the intraluminal contour twice for each image, as well as with ADDER. Intra-observer variabilities for ICSAs were found to be excellent (-1.454 +/- 3.51% for E1, 0.96 +/- 5.4% for E2). The inter-observer variability was 2.1 +/- 4.3%. The success factor for ADDER was 89%. Its intra-observer variability was null, as the method always finds a unique contour. The correlation between the automatically detected ICSA and the manual ICSA was: r = 0.99 (y = 1.03x + 0.89 mm2). Morphometric variations between manually and automatically traced contours, analyzed by the centerline method, were 100 +/- 140 mm on average. In conclusion, the ADDER automatic contour detection applied to IVUS images is robust and characterized by small systematic and random errors; therefore, quantitative IVUS is a useful tool in clinical research trials.

Blood Vessels↗

[Use and significance of intravascular ultrasonic imaging].

Intravascular ultrasound (IVUS) imaging of coronary arteries has recently become possible in vivo with the improvements achieved in the miniaturisation of ultrasound transducers. IVUS provides informations complementary to angiography, and is considered as the gold standard for the assessment of lumen size, plaque thickness and plaque distribution. As formerly demonstrated by pathological studies, IVUS also reveals an underestimation of plaque thickness with angiography and an incomplete assessment of the true morphologic distribution of the plaque burden. Among its clinical applications, IVUS can be used to monitor revascularisation procedures, and may provide very accurate measurements of progression or regression of coronary atherosclerosis and of the extent of posttransplant vasculopathy. IVUS was employed successfully to assess and optimize the results of percutaneous transluminal coronary angioplasty. Clinical studies have shown that the risk of restenosis is inversely proportional to the size of the postprocedural lumen. With the guidance of percutaneous transluminal angioplasty by IVUS, balloon size and inflation pressures were increased, and better results were obtained with larger lumen size in comparison to the results of the procedures assessed by angiography alone. These improvements contributed to abandon the anticoagulation after stent implantation in most cases. In spite of the valuable information provided by IVUS, its role in clinical settings should still be defined IVUS prolongs the revascularisation procedure and enhances its costs and risks. Thus, the cost effectiveness of IVUS in its clinical application should be determined by prospective studies.

Angioplasty, Balloon, Coronary↗

Intravascular imaging.

Based on three-dimensional (3D) information, quantitative data such as plaque volume can be calculated. The procedure includes automatic contour detection based in image segmentation methods and greatly speeds up clinical evaluation. With the use of additional X-ray information, the true tortuous vessel geometry can be reconstructed in 3D. This allows, by numerical modelling techniques, to calculate endothelial shear stress values which in turn may indicate sites prone to stenosis. With a decorrelation technique for radio frequency (RF) echo information from sequential data in the same beam direction and integration method over the entire cross section, blood velocity can be shown colour-coded during the cardiac cycle, while even blood flow quantification seems to be possible. In vitro as well as animal experiments have shown the feasibility of the method. Intravascular imaging can be used to study the biomechanical properties of atheroma components. Local radial strain as a measure of local tissue hardness can be estimated in principle. Hard or soft plaques can be identified from the strain images independently of the echogenic contrast between plaque and vessel wall.

Angiography↗

Flow estimation using an intravascular imaging catheter.

Coronary flow assessment can be useful for determining the hemodynamic severity of a stenosis and to evaluate the outcome of interventional therapy. We developed a method for measuring the transverse flow through the imaging plane of an intravascular ultrasound (IVUS) catheter. This possibility has raised great clinical interest since it permits simultaneous assessment of vessel geometry and function with the same device. Furthermore, it should give more accurate information than combination devices because lumen diameter and velocity are determined at the same location. Flow velocity is estimated based on decorrelation estimation from sequences of radiofrequency (RF) traces acquired at nearly the same position. Signal gating yields a local estimate of the velocity. Integrating the local velocity over the lumen gives the quantitative flow. This principle has been calibrated and tested through computer modeling, in vitro experiments using a flow phantom and in vivo experiments in a porcine animal model, and validated against a Doppler element containing guide wire (Flowire) in humans. Originally the method was developed and tested for a rotating single element device. Currently the method is being developed for an array system. The great advantage of an array over the single element approach would be that the transducer has no intrinsic motion. This intrinsic motion sets a minimal threshold in the detectable velocity components. Although the principle is the same, the method needs some adaptation through the inherent different beamforming of the transducer. In this paper various aspects of the development of IVUS flow are reviewed.

Animals↗

Intravascular MR imaging and intravascular MR-guided interventions.

Intravascular MR technology, using an intravascularly placed MR receiver probe to acquire high-resolution angiographic MR images (i.e. intravascular MR imaging) and to guide cardiovascular interventional therapies (i.e. intravascular MR-guided interventions), is a new, very attractive development in the field of MR imaging. The new technology offers unique advantages for cardiovascular imaging and interventions, including superior contrast capability and multiplanar imaging capabilities without the use of contrast agents and with no risk of ionizing radiation. Thecombination of intravascular MR techniques with other advanced MR imaging techniques, such as functional MR imaging, will open new avenues for the future comprehensive management of cardiovascular atherosclerotic disease. Further improvements in intravascular MR fluoroscopy with true real-time display, analogous to X-ray fluoroscopy, will dramatically establish the role of intravascular MR technology in modern medicine.

Journal Article↗

A novel realistic three-layer phantom for intravascular ultrasound imaging.

Intravascular ultrasound (IVUS) is an imaging modality that experienced a tremendous development over the last 20 years. Phantoms for IVUS are rare and poorly documented. The aim of this paper is to propose an original IVUS phantom that has geometries and specular textures closer to those of coronary arteries than conventional tube-like phantoms. The proposed phantom has a three-layer aspect, reproducing the intima, media and adventitia that compose the arterial wall. It is made of an agar-based compound, with water, glycerol and cellulose particles. Fourteen phantoms were quantified using IVUS. Six phantoms were evaluated by both photomacroscopy and IVUS. There was an excellent correlation between phantom dimensions evaluated by photomacroscopy and the nominal values (mold dimensions). The IVUS quantification of the phantom was closely correlated to the measurements obtained by photomacroscopy. These results demonstrate that a multilayer phantom, with known and reproducible dimensions and with realistic geometric and echographic properties has been developed.

Arteries↗

Comparison of texture analysis methods for the characterization of coronary plaques in intravascular ultrasound images.

Intravascular Ultrasound (IVUS) is a diagnostic imaging technique that provides tomographic visualization of coronary arteries. The aim of this study was to evaluate five texture analysis techniques and determine their ability to distinguish between plaque lesions of different composition. Using histological correlation, regions of calcified, fibrous, and necrotic core plaque were chosen from 27 coronary plaques. First-order statistics, Haralick's method, Laws' texture energy method, the neighborhood gray-tone difference matrix method, and texture spectrum features were examined using discriminant analysis. Self-validation indicated that Haralick's method yielded the most accurate results, with resubstitution and cross-validation error rates of 0.00 and 14.76%, respectively. Further optimization gave error rates of 6.67%, using only two discriminating features, IDM and entropy.

Calcinosis↗