OCT的临床和研究应用.ppt

* 47号 * * 对斑块内的微通道进行数量分组，结果提示微通道的数量对斑块稳定性有明显的影响。OCT横截面上明确出现两个或两个以上的微通道TCFA发生率为64%，同样的，OCT可见一个微通道的TCFA发生率为40%；而临床上OCT没有观察到微通道出现的TCFA发生率仅为21%。三组之间统计学上有明显的差异。 该研究结果进一步提示临床医生，微通道的出现提示斑块不稳定性的变化，同时是否能够这样推测随微通道的数量增加斑块不稳定性，即出现TCFA斑块也逐渐增加。可能原因是斑块内的微通道作为斑块与血管内、外物质交换的渠道使包括炎症因子、脂质成分进一步扩大脂质核心面积。 * Figure 3. Comparison of frequency of positive remodeling according to number of microchannels. When categorized into 3 groups according to number of microchannels, frequency of positive remodeling (36% in group with 0, 50% in group with 1, and 79% in group with 2; p 0.007) was signi?cantly different. * * * This slide shows the information that can be gathered from IVUS (20Mhz) and from OCT imaging. These are corresponding cross sections within a stent, imaged by both, IVUS in the upper panels and by OCT in the lower panels. The images represent the same spots within a coronary artery (A, B, C) , and illustrate the different quality of information that can be obtained by OCT as compared to conventional grey scale IVUS. In example A, 3 layers of stents can be seen. OCT is able to clearly visualize the individual stent struts, the neotinimal layers separating the different stents and the very thin coverage of the most inner, luminal stent struts. In example B, a bright, eccentric and relatively thick neointimal layer can be seen In example C, again an eccentric neotinimal layer is visible, but please note the completely different , low-reflective and speckled apperance of the neointma. Thus, OCT does not only allow to visualize very thin strut coverage, but also allows to measure the thickness of the neointimal layer and, importantly, gives a sense of the quality of the tissue (based on its optical properties) * 右边的图注：(A to C) Histologic sections from a 65-year-old woman with a PES implanted in the left circum?ex artery 14 months antemortem, who died of traumatic brain injury. (A)A low-power image shows a patent lumen with moderate neointimal growth; (B) foamy macrophage in?ltratio