title: A new method for assessment of plaque vulnerability based on vasa vasorum imaging, by using contrast-enhanced intravascular ultrasound and differential image analysis.
abstract: BACKGROUND
  Increased neovascularization in vasa vasorum and atherosclerotic plaques has recently been identified as a common feature of inflammation and plaque vulnerability. Microbubble contrast agents, which have been used for intravascular imaging, can be used to trace neovascularization. The aim of the study was to detect and evaluate the density of vasa vasorum in non-culprit coronary atherosclerotic plaques of patients with acute coronary syndrome.
  
  
  METHODS
  We have studied intravascular ultrasound (IVUS) signals before, during, and after intracoronary injection of microbubbles, proximal to non-culprit atherosclerotic plaques in 16 patients with acute coronary syndrome. Analyses were accomplished using a computational algorithm for the detection of contrast perfusion in such contrast-enhanced sequences. Perfusion density was evaluated by the mean enhancement in the region of interest provided by this difference-imaging technique.
  
  
  RESULTS
  Qualitative and quantitative analysis of the pre- and post-injection images showed a significant enhancement in the grey-scale intensity of intima-media and adventitia after injection (intima-media: from 6.0+/-2.5 to 7.9+/-3.3%, p=0.006 and adventitia: from 7.1+/-2.2 to 7.6+/-2.5%, p=0.035).
  
  
  CONCLUSIONS
  Contrast-enhanced intravascular imaging is a novel, yet clinically available, technique that has the potential to enhance IVUS-based characterization of atherosclerotic plaques. The technique introduces a new perspective to the detection of vulnerable plaques and warrants further investigations.
authors: First Department of Cardiology, Hippokration Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece.
authors: Manolis
authors: M
authors: Vavuranakis
authors: Ioannis A
authors: IA
authors: Kakadiaris
authors: Sean M
authors: SM
authors: O'Malley
authors: Theodore G
authors: TG
authors: Papaioannou
authors: Elias A
authors: EA
authors: Sanidas
authors: Morteza
authors: M
authors: Naghavi
authors: Stéphane
authors: S
authors: Carlier
authors: Dimitrios
authors: D
authors: Tousoulis
authors: Christodoulos
authors: C
authors: Stefanadis
mesh_terms: D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006801:Humans; D018084:Ultrasonography, Interventional; D014651:Vasa Vasorum / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media