Published online before print August 31, 2004, 10.1148/radiol.2331030914
Vascular Remodeling in Atherosclerotic Femoral Arteries: Three-dimensional US Analysis1
Mariann Gyöngyösi, MD, PhD,
Christoph Strehblow, MD,
Markus Haumer, MD,
Paul Wexberg, MD, BM,
Wolfgang Sperker, MD,
Stephan Lehr, BS,
Dietmar Glogar, MD, FESC,
Gerard Pasterkamp, MD, PhD and
Erich Minar, MD
1 From the Divs of Cardiology (M.G., C.S., P.W., W.S., D.G.) and Angiology (M.H., E.M.), Depts of Internal Medicine II and Medical Computer Sciences, Section of Clinical Biometrics (S.L.), Univ of Vienna, Wahringer Gurtel 18–20, A-1090 Vienna, Austria; and Heart Lung Institute, Utrecht, the Netherlands (G.P.). Received Jun 10, 2003; revision requested Aug 26; revision received Dec 10; accepted Jan 13, 2004. Address correspondence to M.G. (e-mail: mariann.gyongyosi@univie.ac.at).
View larger version (54K):
[in a new window]
|
Figure 1. Schematic illustration of arterial remodeling types in coronary arteries in a single culprit lesion. Light-gray circles represent arterial lumen.
|
|
View larger version (89K):
[in a new window]
|
Figure 2. Longitudinal view of position of sonographic tip, which continuously records the US signs of plaques, within intravascular US (IVUS) catheter.
|
|
View larger version (99K):
[in a new window]
|
Figure 3. Three-dimensional intravascular US (IVUS) analysis: The lumen and EEM contours, measured in cross sections of 0.1 mm each (top [transverse view] and bottom left [longitudinal view]), are automatically delineated and displayed. Lumen and EEM CSAs in one segment are measured (top right [transverse view]). Plaque-plus-media CSA is calculated as difference between EEM CSA and lumen CSA. The plaque burden is then calculated (bottom right). Expansive remodeling in response to growing plaque can be observed in this segment (top right).
|
|
View larger version (24K):
[in a new window]
|
Figure 5. Left: Scatterplot with regression line depicts dominant expansive remodeling with high correlation (r = 0.788, P < .001, y = 8.17 + 0.93x) between plaque-plus-media CSA and EEM CSA in 76-year-old man. Right: Corresponding computer-assisted graphic reconstruction of the vessel (only the segment containing the lesion, not the reference segments) shows that at least 80% of the EEM CSAs are above the individual reference value (the mean EEM CSA, calculated as the mean value of the EEM CSAs in the proximal and distal reference segments).
|
|
View larger version (23K):
[in a new window]
|
Figure 6. Left: Scatterplot depicts dominant constrictive remodeling of femoral artery with no significant correlation (r = 0.056, P > .5) between plaque-plus-media CSA and EEM CSA in 73-year-old woman. Right: Corresponding computer-assisted graphic reconstruction of the vessel (only the segment containing the lesion, not the reference segments) shows that at least 80% of the EEM CSAs are below the individual reference value.
|
|
View larger version (24K):
[in a new window]
|
Figure 7. Left: Scatterplot with regression line depicts mixed remodeling with moderate correlation (r = 0.121, P < .05, y = 17.1 + 0.13x) between plaque-plus-media CSA and EEM CSA in 66-year-old man. Right: Corresponding computer-assisted graphic reconstruction of the vessel (only the segment containing the lesion, not the reference segments) shows EEM values both above and below the individual reference value.
|
|
Copyright © 2004 by the Radiological Society of North America.
), plaque-plus-media (
), and EEM (
) contours in five randomly selected patients and in 5.6-cm-long artery in one patient with nonsignificant plaque (bottom right graph) show different responses of the EEM to plaque growth. Dashed line represents reference EEM area. dist. = distal, prox. = proximal, ref. = reference segment.