Background: Although napkin-ring sign (NRS) plaques assessed by multidetector computed tomography (MDCT) is identified as a high-risk feature, the detailed morphological features are still unknown. The purpose of this study was to elucidate the morphological features of the MDCT-assessed NRS using intravascular ultrasound (IVUS).
Methods: We evaluated 204 plaques in 193 patients with non-ST-elevation acute coronary syndrome who were diagnosed using 128-slice MDCT and were assessed using IVUS prior to coronary intervention. Morphology was compared between plaques with and without MDCT-assessed NRS. Severe IVUS-assessed attenuation was defined as an attenuation angle >180°.
Results: NRS was detected in 49 lesions. MDCT-assessed plaque attenuation was lower (p<0.0001), and cross-sectional plaque areas at lesion sites, remodeling index, and the prevalence of positive remodeling were greater, in lesions with NRS (p<0.005, p<0.0001, and p<0.0001, respectively). Furthermore, the IVUS-assessed remodeling index and prevalence of severe attenuation and speckled echo appearance were significantly greater in lesions with NRS (p<0.01, p<0.0001, and p<0.0001, respectively). Using multivariate analysis, IVUS-assessed speckled echo appearance was identified as an independent predictor of MDCT-assessed NRS (odds ratio, 3.59; 95% confidence interval, 1.49-8.66; p<0.005).
Conclusion: MDCT assessment of NRS may be associated with larger heterogeneous necrotic cores and greater positive remodeling.
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http://dx.doi.org/10.1016/j.ijcard.2016.03.057 | DOI Listing |
JACC Cardiovasc Interv
November 2024
West of Scotland Regional Heart & Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom. Electronic address:
JACC Cardiovasc Interv
December 2024
National Institute of Cardiology, Warsaw, Poland. Electronic address:
JACC Cardiovasc Interv
October 2024
Seoul National University Hospital, Seoul, Republic of Korea. Electronic address:
Ultrasonics
December 2024
Department of Physics, Concordia University, Montreal, Quebec H4B 1R6, Canada; Department of Biology, Concordia University, Montreal, Quebec H4B 1R6, Canada. Electronic address:
Clinical ultrasound contrast agent microbubbles remain intravascular and are between 1-8 µm in diameter, with a volume-weighted mean size of 2-3 µm. Despite their worldwide clinical utility as a diagnostic contrast agent, and their continued and ongoing success as a local therapeutic vector, the fundamental interplay between microbubbles - including bubble-bubble interaction and the effects of a neighboring viscoelastic vessel wall, remain poorly understood. In this work, we developed a finite element model to study the physics of the complex system of two different-sized bubbles (2 and 3 µm in diameter) confined within a viscoelastic vessel from a resonance response perspective (3-12 MHz).
View Article and Find Full Text PDFInn Med (Heidelb)
December 2024
Innere Medizin I, Schwerpunkt Gastroenterologie, Sana Klinikum Lichtenberg, Berlin, Deutschland.
In patients with chronic inflammatory bowel disease (IBD), endoscopic techniques (including capsule techniques and balloon enteroscopy for the small intestine), ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are primarily used as often complementary imaging techniques. Radiation exposure needs to be kept in mind when using CT and conventional X‑ray-techniques. Therefore, most importantly, ultrasound and MRI have changed the routine diagnostics of intestinal diseases.
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