IVUS tracking: advantages and disadvantages of intravascular ultrasound in the detection of artery geometrical features and plaque type morphology
Intravascular ultrasound (IVUS) is an invasive coronary imaging modality which provides insights in the diagnosis and therapy of coronary artery disease. The main advantage of IVUS compared to other coronary imaging techniques such as traditional invasive angiography, is that it allows the tomographic assessment of: the lumen area, the external elastic membrane area, the plaque size, the distribution and the composition of the plaque. It can safely detect and characterize the following types of plaques: necrotic core, fibrous plaque and calcified plaque. One other aspect worth mentioning is that it also provides accurate measurement of the luminal dimensions of the artery of interest. With IVUS, lipid-laden lesions appear hypoechoic, fibromuscular lesions generate low-intensity echoes and fibrous or calcified tissues are echogenic. However, IVUS suffers from a few drawbacks directly connected to its innate image quality. For example, calcium obscures the underlying wall, a phenomenon called acoustic shadowing. One other major image quality issue that emerges from the use of IVUS is the so-called speckle noise, which is the main reason for the grainy texture of IVUS images. This results to poor quality images, which makes their interpretation and processing nontrivial for computed-based diagnostic systems.
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