Improved Reproducibility of Intravascular Ultrasound Assessment of Coronary In-Stent Neointima With the Use of an Echogenic Contrast Agent

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The present study evaluated a new technique that has the potential to improve the border detection of in-stent neointima using an echogenic contrast agent during intravascular ultrasound (IVUS). To confirm the reproducibility of IVUS imaging for measuring the cross-sectional in-setent neointima area, inter- and intra-observer variability and correlation were determined. Conventional IVUS (plain IVUS) and IVUS using a contrast agent (contrast IVUS) were performed in 24 subjects 6.5±1.5 months after undergoing a Palmaz-Schatz coronary stent implant. Conventional IVUS delineated completely the in-stent neointima in 6 subjects (25%). In the remaining 18 subjects (75%), delineation of the neointima was incomplete despite the use of various combinations of imaging conditions (eg, transmission, compress, post-process). With contrast IVUS, the boundary of the neointima, and therefore the neointima area, was clearly distinguishable, and this resulted in complete delineation of the neointima in all 24 subjects. With a contrast agent, inter- and intra-observer variability significantly decreased (0.94±0.69mm^2 conventional IVUS vs 0.37±0.40mm^2 contrast IVUS, p<0.001;0.69±0.56mm^2 conventional IVUS vs 0.07±0.10mm^2 contrast IVUS, p<0.0001;respectively). Thus, contrast IVUS provides a reproducible method for the quantiative analysis of in-stent neointima with excellent inter- and intra-observer correlation.
社団法人日本循環器学会の論文
2001-06-20