| Background and Objective: Coronary atherosclerotic heart disease isa chronic ischemia and hypoxia heart disease. Due to atheromatous plaqueformation, vascular narrowing or occlusion, or functional spasm ofcoronary artery. According to statistics, in western countries, CHD hasbecome the leading cause of death, some survey of our country also foundthat the incidence of CHD is rising year by year, and the onset age tend tobe younger in recent years. CHD has been called "the first kille " becauseof its universality and severity, causing more and more attention by people.Since Dr.Stone created the first coronary angiography in1959, people usethis2D imaging technology to observe the lesion site and judge narrowdegree, and create a new era of diagnosis and treatment about CHD. Withthe developing of medical technology, people found CAG can only reveallumen outline filled with contrast medium, and easy to be influenced by projecting angle and reference vessels，so the results are often lack ofaccuracy. Expecially in the intermediate coronary stenosis, people oftenmiss the best treatment time because of underestimating the lesions.Intravascular ultrasound was invented in the20th century，it can get thereal-time360°cross-section image through mini ultrasound probe on top ofthe catheter, and translate the data into gray-scale images. This technologycan not only show the structure of display wall clearly, measure of thelumen diameter accurate, still can identify the lipid, fiber, calcium andnecrosis lesion, thus find the early lesions which CAG can’t show. Sincethe last decade years, iMAP-IVUS has been invented based on IVUS. It useultrasound radio frequency signal, and analyze the data through the powerspectrum. iMAP-IVUS use different colors to distinguish different plaquesnature, to reconstruct the color images. To some degree, it makes up for thelack of gray-scale images.In this study, comparing the nineteen patients’ analysis results ofquantitative coronary angiography (QCA) and IVUS，to evaluate theapplication value and safety of IVUS in clinical practice. Furtherly, useiMAP-IVUS analysis the morphological characteristics of the plaques inintermediate coronary stenosis, preliminary discuss the relationshipbetween remodeling and unstable plaques.Methods: Select nineteen patients with “chest pain” from November2010to December2011, who underwent CAG and IVUS of intermediate coronary stenosis.To analyze the atherosclerotic plaques through QCA and IVUSrespectively. The MLD、％AS、and％DS were measured for comparativequantitative analysis. The characteristics and compositions of plaques wereobserved by iMAP-IVUS for qualitative analysis. PCI was performed tothe patient with%AS≥70%showed by CAG. The datas were conductedusing statistical package SPSS10.0, to compare the results of two differentmethods.Result:1. CAG showed that the MLD，％DS and％AS weresignificantly lower than those observed by IVUS (P <0．05)．2. IVUS showed the intermediate coronary stenosis had more softplaque,less calcified plaque,more eccentric plaque and positiveremodeling．3. iMAP-IVUS showed14TCFA in19intermediate coronary stenosislesions,and also showed more soft and TCFA plaque,more eccentricplaque,and less calcified plaque in positive remodeling.4. Further PCI was performed in4patients with%AS≥70％.Meanwhile，the parameters before and after stenting were measured byIVUS．The MLA,MLD,％AS, and％DS after stenting were significantlyhigher than those before intervention therapy(P <0．05)．IVUS examinationis safe.Conclusion: This study show that IVUS may definite the characteristics and severity of the clinical suspected coronary heart disease,improving the accuracy of the diagnosis rate. Furtherly speaking, IVUShas the special advantage in assessment and guiding the next treatment ofintermediate coronary stenosis,and used safely. As a result, IVUS is thepowerful supplementary for diagnosis of coronary heart disease bycoronary angiography, and ti is worthy of reasonable application in clinicalwork. |
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