An intravascular coronary plaque elasticity reconstruction method using limited depth penetration ultrasound signals
Résumé
Vulnerable atherosclerotic plaque (VP) rupture is the leading cause of acute coronary syndrome, myocardial infarction and
stroke in the Western world (Go et al. 2013). Although past studies have identified fibrous cap thickness (Capthick) as the
primary predictor of coronary plaque rupture (Virmani et al. 2006), biomechanical studies have recognized peak cap stress
(PCS) as an additional key predictor of plaque disruption (Ohayon et al. 2008). Quantification of PCS amplitude requires
not only an accurate description of plaque morphology but also a precise knowledge of the mechanical properties of plaque
components. An early and accurate determination of these properties remains an essential step to implement preventive
therapeutic strategies.
A previous approach (named iMOD for imaging modulography) has been conducted by our group to reconstruct
the Young’s modulus map (i.e. modulogram) from intravascular ultrasound (IVUS) strain-elastogram (Le Floc’h et al. 2009). However,
one major limitation of such a method is the need to accurately estimate the strain field in the entire lesion, which may be
often difficult when using HD-IVUS techniques with limited depth penetration signals (Kobayashi et al. 2014). Therefore, an extended
iMOD approach (E-iMOD), based on the continuum mechanics theory prescribing the strain field in the limited atherosclerotic
endoluminal region, was designed and successfully applied to coronary lesions of patients imaged in vivo with IVUS.
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