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摘要: 血管内超声、光学相干断层成像等腔内影像学检查可对血管壁进行断层横截面成像，可以准确地识别和评估病变性质、指导介入治疗，提高即刻手术效果和远期预后，在最新的专家共识及指南中推荐将腔内影像学检查用于冠心病患者经皮冠状动脉介入治疗的指导及优化。然而，多种腔内影像学技术均有其优势与局限性，多模态腔内影像技术应运而生。目前已有数种多模态腔内影像导管应用于科研及临床工作，在检测高危斑块、指导经皮冠状动脉介入治疗及评估斑块进展等方面为医生提供更加准确和全面的组织学和形态学信息。
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关键词:
- 经皮冠状动脉介入治疗 /
- 冠状动脉粥样硬化性心脏病 /
- 多模态腔内影像 /
- 高危斑块
Abstract: Intravascular imaging, such as intravascular ultrasound and optical coherence tomography, can provide cross-sectional imaging of the coronary artery, which can accurately assess the morphology of the lesion, guide percutaneous coronary intervention, and improve the immediate outcome and long-term prognosis. Intravascular ultrasound and optical coherence tomography are recommended for percutaneous coronary intervention guidance to reduce ischemic events in the latest expert consensus and guidelines. However, intravascular imaging techniques have their own advantages and limitations, thus multimodality intravascular imaging has emerged. Several multimodality intravascular imaging catheters have been used in scientific research and clinical scenario, providing interventional cardiologists with more accurate and comprehensive information in detecting high-risk plaques, guiding percutaneous coronary intervention, and evaluating plaque progression. -
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表 1 腔内影像设备对斑块形态学特征及微结构的识别能力
Table 1. Recognition ability of intracavitary imaging equipment for plaque morphological characteristics and microstructure
腔内影像设备 管腔狭窄 斑块负荷 纤维帽 脂质核心 活动性炎症 血管重构 IVUS +++ +++ +- + - +++ OCT +++ - +++ + + - NIRS - - - +++ - - NIR(A)F - - - + ++ - FLIm - - - + + - IVPA +- +- - +++ + +- NIRS-IVUS +++ +++ +- +++ - +++ IVUS-OCT +++ +++ +++ + + +++ OCT-NIRS +++ - +++ +++ + - OCT-NIR(A)F +++ - +++ + ++ - NIRF-IVUS +++ +++ +- + ++ +++ FLIm-IVUS +++ +++ +- + + +++ FLIm-OCT +++ - +++ + + - IVPA-IVUS +++ +++ +- +++ + +++ 
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