Lesion Morphology
In a normal coronary artery, an ultrasound reflection is generated at two tissue interfaces: at the border between blood and the leading edge of intima and at the external elastic membrane (EEM) located at the media-adventitia border. The resulting three-layered structure consists of the tunica intima (bright, relatively echogenic layer compared to lumen and media), media (dark, less echogenic layer compared to intima) and adventitia (bright). Tunica media has lower ultrasound reflectance due to lower content of collagen and elastin (highly reflective materials) compared to intima and adventitia. The trailing edge of the intima, internal elastic membrane (IEM), cannot always be distinguished clearly on IVUS images. Similarly, IVUS cannot detect the outer border of adventitia due to comparable echoreflectivity of adventitia and periadventitial tissue.1,2
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
2. Circulation. 2001;103:604-616
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
1. J Am Coll Cardiol. 2009, 2(1): 65-72
2. JACC Cardiovascular Interv. 2011, 4(5): 495-502
1. Circulation. 1995, 91(7): 1959-1965.
2. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
1. Am J Cardiol 2011;108:1547–1551
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
2. Am J Cardiol. 2006 Jan 1;97(1):29-33
1. J Am Coll Cardiol. 2001 April, 37(5): 1478-92
2. Catheter Cardiovasc Interv. 2014 Dec 1;84(7):1115-22
Artifacts
1. JACC Cardiovasc Imaging. 2017 Aug;10(8):869-879