Intravascular detection of microvessel infiltration in atherosclerotic plaques: An intraluminal extension of acoustic angiography.

摘要

Cardiovascular disease is the leading cause of death worldwide, surpassing both stroke and cancer related mortality with 17.5 million deaths in 2014 alone. Atherosclerosis is the build-up of fatty deposits within arteries and is responsible for the majority of cardiovascular related deaths. Over the past decade, research in atherosclerosis has identified that a key limitation in the appropriate management of the disease is detecting and identifying dangerous fatty plaque build-ups before they dislodge and cause major cardiovascular events, such as embolisms, stroke, or myocardial infarctions. It has been noted that plaques vulnerable to rupture have several key features that may be used to distinguish them from asymptomatic plaques. One key identifier of a dangerous plaque is the presence of blood flow within the plaque itself since this is an indicator of growth and instability of the plaque. Recently, a superharmonic imaging method known as "acoustic angiography" has been shown to resolve microvasculature with unprecedented quality and could be a possible method of detecting blood vessel infiltration within these plaques.;This dissertation describes the material and methods used to move the application of "acoustic angiography" to a reduced form factor typical of intravascular catheters and to demonstrate its ability to detect microvasculature. The implementation of this approach is described in terms of the contrast agents used to generate superharmonic signals, the dual-frequency transducers to image them, and the hardware needed to operate them in order to establish how these design choices can impact the quality of the images produced. Furthermore, this dissertation demonstrates how image processing methods such as adaptive windowing or automated sound speed correction can further enhance image quality of vascular targets. The results of these chapters show how acoustic angiography may be optimized using engineering considerations both in signal acquisition and post processing. Overall, these studies demonstrate that acoustic angiography can be performed using a catheter-deployable dual-frequency transducer to detect microvasculature through superharmonic imaging methods.