Observation of plaque behavior and tissue characterization of coronary plaque using speckle tracking intravascular ultrasound (ST-IVUS) and iMap imaging system

• Published in: Heart and vessels 2023, Vol.38 (1), p.131-135
• Main Authors: Tanaka, Shinichiro, Kawasaki, Masanori, Noda, Toshiyuki, Segawa, Tomonori, Tsugita, Natsumi, Fuseya, Takahiro, Iwama, Makoto, Yagasaki, Hiroto, Kawaguchi, Tomonori, Kato, Takashi, Watanabe, Sachiro, Minagawa, Taro, Minatoguchi, Shinya, Okura, Hiroyuki
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - etiology; Aged, 80 and over; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Cardiovascular disease; Color; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Female; Fibrosis; Graphic Report; Heart; Heart diseases; Humans; Image processing; Lipids; Mechanical properties; Medicine; Medicine & Public Health; Plaque, Atherosclerotic - pathology; Plaques; Stents; Systole; Tissues; Tracking; Ultrasonic imaging; Ultrasonography, Interventional - methods; Ultrasound; Vascular Surgery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-022-02056-5

Tissue characterization plays an important role in the development of acute coronary syndromes. iMap is an intravascular ultrasound (IVUS) tissue characterization system that provides useful information by reconstructing color-coded maps. Mechanical properties due to dynamic mechanical stress during a cardiac cycle may also trigger vulnerable plaque. Speckle tracking IVUS (ST-IVUS) has been introduced to observe plaque behavior in relation to mechanical properties. We report the case of an 84-year-old woman with stable coronary artery disease who underwent percutaneous coronary intervention, at which time IVUS demonstrated mainly three low echoic areas like lipid pools with thick fibrous caps. Pathological evaluation with iMap revealed that one low echoic area was occupied with necrotic tissue and that the other two areas occupied fibrotic. Although those tissue characterizations were different, they showed similar stretching behavior at systole by ST-IVUS which depicted plaque behavior from IVUS images using a color mapping. The mechanical properties of individual coronary plaques may differ depending on the tissue disposition. It is necessary to consider mechanical properties using ST-IVUS as well as to evaluate tissue characterization in plaque risk stratification.