Optical coherence tomography

光学相干层析成像
  • 文章类型: Journal Article
    背景:根据泪膜破裂时间(TBUT),比较使用眼前节光学相干断层扫描(AS-OCT)进行角膜和角膜上皮厚度标测的可重复性和可重复性。
    方法:根据TBUT将纳入的眼睛分为三个亚组(第1组:TBUT≤5s,组2:5s10s)。由两名操作员分别对所有眼睛进行三次成像,以基于包含9mm直径区域的空间区域获得角膜和角膜上皮的厚度图(TM)。每个TM由25个区域组成。操作人员(可重复性)和操作人员间(可重复性)标准偏差(Sws),变异系数(CoV),计算并比较了所有区域的测试之间的组内相关系数(ICC)。
    结果:总之,纳入67名受试者的132只眼(第1、2和3组分别为50、47和35只眼)。大多数区域的角膜上皮厚度和角膜厚度的ICC>0.75。配对比较显示,AS-OCT在第1组的可重复性低于第2组和第3组(P<0.05)。然而,第2组和第3组显示相似的结果。角膜上皮厚度的Sws和CoV没有显着差异。虽然在大多数区域中没有观察到角膜厚度的显着差异。
    结论:TBUT显著影响角膜和角膜上皮厚度测量的可重复性。泪膜稳定性差需要仔细评估角膜上皮厚度。
    BACKGROUND: To compare the repeatability and reproducibility of corneal and corneal epithelial thickness mapping using anterior segment optical coherence tomography (AS-OCT) according to tear film break-up time (TBUT).
    METHODS: The included eyes were divided into three subgroups according to TBUT (group 1: TBUT ≤ 5 s, group 2: 5 s < TBUT ≤ 10 s, and group 3: TBUT > 10 s). All eyes were imaged separately thrice by two operators to obtain the thickness maps (TMs) of the cornea and corneal epithelium based on spatial zones encompassing a 9-mm-diameter area. Each TM consisted of 25 areas. Intraoperator (repeatability) and interoperator (reproducibility) standard deviations (Sws), coefficients of variation (CoVs), and intraclass correlation coefficients (ICCs) among the tests were calculated and compared in all the areas.
    RESULTS: Altogether, 132 eyes of 67 subjects were included (50, 47, and 35 eyes in groups 1, 2, and 3; respectively). The ICCs of corneal epithelial thickness and corneal thickness were > 0.75 in most of the areas. Pairwise comparisons showed that AS-OCT exhibited lower repeatability in group 1 than in groups 2 and 3 (P < 0.05). However groups 2 and 3 showed similar results. Sws and CoVs of corneal epithelial thickness exhibited no significant interoperator differences. While no significant differences were observed in corneal thickness in most of the areas.
    CONCLUSIONS: TBUT significantly influences the repeatability of corneal and corneal epithelial thickness measurements. Poor tear film stability requires careful evaluation of corneal epithelial thickness.
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  • 文章类型: Journal Article
    已经提出了许多基于硬件和基于软件的策略来消除运动伪影,以改善3D光学相干断层扫描(OCT)图像质量。然而,基于硬件的策略必须采用额外的硬件来记录运动补偿信息。许多基于软件的策略必须以更长的采集时间为代价需要额外的扫描以进行运动校正。为了解决这个问题,提出了一种用于眼前节OCT体积成像的运动伪影校正和运动估计方法,无需额外的硬件和冗余扫描。已经在实验中证明了体内3D-OCT的具有亚像素精度的运动校正效果。此外,成像对象的生理信息,包括呼吸曲线和呼吸频率,已经使用所提出的方法进行了实验提取。所提出的方法为眼科的科学研究和临床诊断提供了强大的工具,并且可以进一步扩展到其他生物医学体积成像应用。
    A number of hardware-based and software-based strategies have been suggested to eliminate motion artifacts for improvement of 3D-optical coherence tomography (OCT) image quality. However, the hardware-based strategies have to employ additional hardware to record motion compensation information. Many software-based strategies have to need additional scanning for motion correction at the expense of longer acquisition time. To address this issue, we propose a motion artifacts correction and motion estimation method for OCT volumetric imaging of anterior segment, without requirements of additional hardware and redundant scanning. The motion correction effect with subpixel accuracy for in vivo 3D-OCT has been demonstrated in experiments. Moreover, the physiological information of imaging object, including respiratory curve and respiratory rate, has been experimentally extracted using the proposed method. The proposed method offers a powerful tool for scientific research and clinical diagnosis in ophthalmology and may be further extended for other biomedical volumetric imaging applications.
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  • 文章类型: Journal Article
    目的:使用光学相干断层扫描(OCT)观察伴有或不伴有黄斑视网膜裂开(MRS)的后巩膜葡萄肿(PSS)的形态学特征。此外,还评估了与后巩膜葡萄肿相关的其他病理性近视性黄斑病变的发生率和严重程度.
    方法:收集440例后巩膜葡萄肿(PSS)和PSS曲率>20×10-3μm-1患者的一般信息和OCT影像学数据。这些患者于2013年1月至2021年6月在哈尔滨医科大学附属第一医院眼科就诊。使用ImageJ软件分析所获得的PSS的OCT图像,以测量沿着布鲁赫膜的曲率。使用四分位数方法将测量的曲率分为四个级别。黄斑视网膜裂孔(MRS)的分类基于视网膜的解剖结构和黄斑视网膜裂孔的位置。伴MRS的PSS患者被分配到MRS组,而无MRS的PSS患者被分配到非MRS组。此外,其他病理性近视黄斑病变的典型OCT变化,如近视脉络膜新生血管(mCNV),近视牵引性黄斑病变(MTM),和近视中央凹(MF),进行记录和评估。
    结果:总共615只眼(328只右眼,本研究招募了440名患者(80名男性和360名女性)的287只左眼)。MRS组159例(36.1%),190只眼(30.9%),而非MRS组包括281例患者(63.9%)和425只眼(69.1%)。两组女性患者的比例明显高于男性患者,右眼比左眼更常见。在MRS组中,MRS的患病率随着PSS的严重程度而逐渐增加。在常见的后极疾病中,视网膜前膜患病率最高(33.2%),而层状黄斑裂孔的患病率最低(5.3%)。在非MRS组中,各组中PSS的比例随着PSS严重程度的增加而逐渐降低(第三和第四水平的患病率相同).在常见的后极疾病中,脉络膜新生血管的患病率最高(41.4%),而层状黄斑裂孔的患病率最低(6.5%)。当比较两组时,在年龄上没有显著差异,性别,和眼睛分布。MRS组黄斑裂隙患病率较高,视网膜脱离,和圆顶状黄斑(17.9%,14.2%,14.8%)与非MRS组(11.3%,9.2%,9.6%)。与MRS组(12.6%)相比,非MRS组脉络膜新生血管的患病率(41.4%)明显更高,而视网膜前膜和板层黄斑孔的患病率在两组之间没有显着差异。
    结论:随着PSS的严重程度,MRS的患病率逐渐增加,MRS的发生与PSS呈正相关,这表明PSS可能导致MRS,而各组中PSS的比例随着非MRS组PSS严重程度的逐渐降低而逐渐降低(第三和第四水平的患病率相同除外).在MRS组中,外黄斑视网膜病变与后巩膜葡萄肿最相关,MRS组黄斑裂孔和视网膜脱离的患病率高于非MRS组,表明MRS可能进一步转变为黄斑裂孔和视网膜脱离等并发症,这会显著影响视力或导致失明。非MRS组的脉络膜新生血管(CNV)患病率明显高于MRS组,提示严重程度较低的PSS更容易发展为CNV。圆顶状黄斑(DSM)似乎在病理性近视的发展中起保护作用。后巩膜葡萄肿曲率的异常改变可能是影响DSM发育和形态的重要因素。
    OBJECTIVE: To observe the morphological characteristics of posterior scleral staphyloma (PSS) with or without macular retinoschisis (MRS) using optical coherence tomography (OCT). Additionally, the incidence and severity of other pathologic myopic maculopathy associated with posterior scleral staphyloma was also evaluated.
    METHODS: General information and OCT imaging data from 440 patients with posterior scleral staphyloma (PSS) and the PSS curvature > 20×10-3 μm-1 were collected. These patients visited the Department of Ophthalmology at the First Affiliated Hospital of Harbin Medical University from January 2013 to June 2021. The obtained OCT images of PSS were analyzed using the Image J software to measure the curvature along the Bruch\'s membrane. The measured curvature was divided into four levels using the quartile method. The classification of macular retinoschisis (MRS) was based on the anatomical structure of the retina and the location of macular retinoschisis. Patients with PSS accompanied by MRS were assigned to the MRS group, while PSS patients without MRS were assigned to the non-MRS group. Additionally, typical OCT changes in other pathologic myopic maculopathy diseases, such as myopic choroidal neovascularization (mCNV), myopic traction maculopathy (MTM), and myopic foveoschisis (MF), were recorded and evaluated.
    RESULTS: A total of 615 eyes (328 right eyes, 287 left eyes) from 440 patients (80 males and 360 females) were recruited in this study. The MRS group consisted of 159 patients (36.1%) with 190 eyes (30.9%), while the non-MRS group consisted of 281 patients (63.9%) with 425 eyes (69.1%). Both groups had a significantly higher proportion of female patients compared to male patients, and the right eye was more commonly affected than the left eye. In the MRS group, the prevalence of MRS increased progressively with the severity of PSS. Among the common posterior pole diseases, epiretinal membrane had the highest prevalence (33.2%), while lamellar macular hole had the lowest prevalence (5.3%). In the non-MRS group, the proportion of PSS in each group decreased progressively (except for an equal prevalence in the third and fourth levels) with increasing severity of PSS. Among the common posterior pole diseases, choroidal neovascularization had the highest prevalence (41.4%), while lamellar macular hole had the lowest prevalence (6.5%). When comparing the two groups, there were no significant differences in age, gender, and eye distribution. The MRS group had a higher prevalence of macular schisis, retinal detachment, and dome-shaped macula (17.9%, 14.2%, 14.8%) compared to the non-MRS group (11.3%, 9.2%, 9.6%). The non-MRS group had a significantly higher prevalence of choroidal neovascularization (41.4%) compared to the MRS group (12.6%), while there were no significant differences in the prevalence of epiretinal membrane and lamellar macular hole between the two groups.
    CONCLUSIONS: The prevalence of MRS increased progressively with the severity of PSS, and the MRS occurrence was positively correlated with PSS, which indicated that PSS may lead to MRS, while the proportion of PSS in each group decreases gradually with the severity of PSS in the non-MRS group decreased progressively (except for an equal prevalence in the third and fourth levels). In the MRS group, outer macular retinoschisiss were most relevant to posterior scleral staphyloma, and the prevalence of macular holes and retinal detachments was higher in the MRS group compared to the non-MRS group, indicating that MRS may further turn into complications such as macular holes and retinal detachments, which can significantly affect vision or lead to blindness. The prevalence of choroidal neovascularization (CNV) was significantly higher in the non-MRS group compared to the MRS group, suggesting that PSS with lower severity is more prone to develop into CNV. Dome-shaped macula (DSM) seems to play a protective role in the development of pathologic myopia, and abnormal changes in posterior scleral staphyloma curvature may be an important factor affecting the development and shape of DSM.
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  • 文章类型: Journal Article
    射线照相检查已成为牙周病和种植牙科诊断工作流程的重要组成部分。然而,射线照相检查不可避免地涉及电离辐射及其相关风险。临床医生和研究人员已经投入了相当大的努力来评估利用非电离成像方式代替传统射线成像的可行性和能力。在临床环境中已经广泛评估了两种这样的模式,即,超声(USG)和磁共振成像(MRI)。另一种模式,光学相干断层扫描(OCT),最近一直在调查。这篇综述旨在对文献进行概述,并总结USG的用法,MRI,和OCT评估牙周和种植体周围组织的健康和病理。临床研究表明,USG可以准确测量牙龈高度和颌骨水平,并对分叉参与进行分类。由于物理限制,即使使用口内探针,USG也可以更适用于牙列的颊表面。临床研究还表明,MRI可以显示软组织炎症和骨水肿的程度,分叉受累部位的骨丢失程度,和牙周骨水平。然而,缺乏通过MRI评估种植体周围组织的临床研究.此外,核磁共振机非常昂贵,占据了很大的空间,并且需要比锥束计算机断层扫描(CBCT)或口内X射线照片更多的时间来完成扫描。OCT评估牙周组织和种植体周围组织的可行性仍有待阐明,因为目前只有临床前研究。OCT的一个主要缺点是它可能无法到达牙周袋的底部,特别是对于炎症,由于血红蛋白吸收近红外光。直到未来的技术突破最终克服USG的限制,MRI和OCT,用于牙周和种植体周围组织常规诊断的实用成像模式仍然是X线平片和CBCT.
    Radiographic examination has been an essential part of the diagnostic workflow in periodontology and implant dentistry. However, radiographic examination unavoidably involves ionizing radiation and its associated risks. Clinicians and researchers have invested considerable efforts in assessing the feasibility and capability of utilizing nonionizing imaging modalities to replace traditional radiographic imaging. Two such modalities have been extensively evaluated in clinical settings, namely, ultrasonography (USG) and magnetic resonance imaging (MRI). Another modality, optical coherence tomography (OCT), has been under investigation more recently. This review aims to provide an overview of the literature and summarize the usage of USG, MRI, and OCT in evaluating health and pathology of periodontal and peri-implant tissues. Clinical studies have shown that USG could accurately measure gingival height and crestal bone level, and classify furcation involvement. Due to physical constraints, USG may be more applicable to the buccal surfaces of the dentition even with an intra-oral probe. Clinical studies have also shown that MRI could visualize the degree of soft-tissue inflammation and osseous edema, the extent of bone loss at furcation involvement sites, and periodontal bone level. However, there was a lack of clinical studies on the evaluation of peri-implant tissues by MRI. Moreover, an MRI machine is very expensive, occupies much space, and requires more time than cone-beam computed tomography (CBCT) or intraoral radiographs to complete a scan. The feasibility of OCT to evaluate periodontal and peri-implant tissues remains to be elucidated, as there are only preclinical studies at the moment. A major shortcoming of OCT is that it may not reach the bottom of the periodontal pocket, particularly for inflammatory conditions, due to the absorption of near-infrared light by hemoglobin. Until future technological breakthroughs finally overcome the limitations of USG, MRI and OCT, the practical imaging modalities for routine diagnostics of periodontal and peri-implant tissues remain to be plain radiographs and CBCTs.
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  • 文章类型: Journal Article
    目的:根据光学相干血管成像(OCTA)的特点,探讨新生血管性年龄相关性黄斑变性(nAMD)患者视网膜下高反射物质(avSHRM)的形成和吸收。
    方法:前瞻性队列研究方法:本研究纳入初治nAMD患者,随访3个月。根据基线时avSHRM的存在将受试者分为avSHRM组和非avSHRM组。定量OCTA特征,包括外植体面积,周边,船舶面积,密度,长度,连接处,端点,疏漏,最大船舶口径,容器分散,并对分形维数进行了评估,测量了avSHRM的三维体积和光密度比(ODR)。比较分析,相关系数和回归模型用于探索与avSHRM形成和吸收相关的因素。
    结果:纳入88例患者(39例女性)的88只眼。与非AVSHRM组相比,AVSHRM组表现出更复杂的脉管系统,以黄斑新生血管(MNV)周长值较高为特征,船舶面积,血管总长度,节点总数和端点总数(均P<0.05),以及最大血管口径(P<0.001)。在多变量模型中,已经根据年龄进行了调整,性别,以及药物的种类,avSHRM吸收与基线平均血管长度相关,最大血管口径和avSHRMODR(标准β=0.274、-0.367和-0.334;P分别=0.049、0.010和0.018),调整后的R²为0.453。
    结论:定量OCTA测量可用于评估nAMD中avSHRM的动力学。具有更复杂脉管系统的患者具有更高的avSHRM形成风险。平均血管长度,最大血管直径和AVSHRMODR在其吸收中起作用。
    OBJECTIVE: To investigate the formation and absorption of avascular subretinal hyperreflective material (avSHRM) in neovascular age-related macular degeneration (nAMD) based on optical coherence tomography angiography (OCTA) characteristics.
    METHODS: Prospective cohort study METHODS: This study included patients with treatment-naïve nAMD and followed up for 3 months. Subjects were classified into avSHRM group and non-avSHRM group based on the presence of avSHRM at baseline. Quantitative OCTA characteristics including explant area, perimeter, vessel area, density, length, junctions, endpoints, lacunarity, maximum vessel caliber, vessel dispersion, and fractal dimension were assessed, three-dimensional volume and optical density ratio (ODR) of avSHRM were measured. Comparison analyses, correlate coefficients and regression models were applied to explore factors associated with avSHRM formation and absorption.
    RESULTS: 88 eyes from 88 patients (39 females) were enrolled. Compared to non-avSHRM group, avSHRM group exhibit a more intricate vasculature, characterized by higher value of macular neovascularization (MNV) perimeter, vessel area, total vessel length, total number of junctions and total number of endpoints (all P < 0.05), as well as the maximum vessel caliber (P < 0.001). In the multivariate model, which has been adjusted for age, gender, and types of medications, avSHRM absorption was correlated with baseline average vessel length, maximum vessel caliber and avSHRM ODR (standardized β = 0.274, -0.367 and -0.334; P = 0.049, 0.010 and 0.018, respectively), with an adjusted R² of 0.453.
    CONCLUSIONS: Quantitative OCTA measurements can be utilized for assessing the dynamics of avSHRM in nAMD. Patients with more complex vasculature are at a higher risk of avSHRM formation. Average vessel length, maximum vessel diameter and avSHRM ODR play a role in its absorption.
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  • 文章类型: Journal Article
    在这项研究中,我们采用了一种将光学相干断层扫描(OCT)与U-Net和视觉几何组(VGG)-Net框架集成在卷积神经网络中的方法,用于动态凝血过程中的三维全血的定量表征.VGG-Net架构,用于识别三个不同的凝血阶段的血滴,包括液滴,凝胶化,和凝固达到高达99%的精度。此外,U-Net架构在有效分割全血的未凝固和凝固部分方面表现出熟练的能力,以及背景。值得注意的是,参数,如未凝固的和凝固的全血段的体积被成功地用于凝固过程的精确定量,这很好地表明了未来临床诊断和分析的潜力。
    In this study, we employed a method integrating optical coherence tomography (OCT) with the U-Net and Visual Geometry Group (VGG)-Net frameworks within a convolutional neural network for quantitative characterization of the three dimensional whole blood during the dynamic coagulation process. VGG-Net architecture for the identification of blood droplets across three distinct coagulation stages including drop, gelation, and coagulation achieves an accuracy of up to 99%. In addition, the U-Net architecture demonstrated proficiency in effectively segmenting uncoagulated and coagulated portions of whole blood, as well as the background. Notably, parameters such as volume of uncoagulated and coagulated segments of the whole blood were successfully employed for the precise quantification of the coagulation process, which indicates well for the potential of future clinical diagnostics and analyses.
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  • 文章类型: Journal Article
    基于光学相干层析成像图像的光学衰减定量分析将提供一种有效的方法来增强诊断能力。在本文中,计算去矿化龋齿标本的光学衰减,以区分正常牙齿和龋齿,并进一步区分龋齿的严重程度。从而实现了龋齿的半自动化诊断。结果表明,龋齿区域的衰减系数约为4.97mm-1±0.206$$4.97\\{\\\mathrm{mm}}^{-1}\\左(\\pm0.206\\右)$$,而正常牙齿约为3.69毫米-1±0.231$$3.69\\{\\\mathrm{mm}}^{-1}\\\\左(\\pm0.231\\右)$$。龋齿区域的衰减系数比正常牙齿高35%。此外,根据光学衰减系数对5类龋齿进行了定性和分类。与健康的牙齿相比,龋齿的衰减系数有明显的差异,表面和牙釉质交界处。本研究为准确的龋齿诊断提供了一种方法,特别是检测早期病变和细微的结构变化。
    Quantitative analysis of optical attenuation based on optical coherence tomography images will offer an effective method to enhance diagnostic capabilities. In this paper, the optical attenuation in demineralized caries specimens was calculated to distinguish between normal teeth and carious teeth and further to differentiate the severity of caries, and thus come to the half-automated diagnosis of dental caries. Results show that the attenuation coefficient in carious regions is approximately 4.97 mm - 1 ± 0.206 $$ 4.97\\ {\\mathrm{mm}}^{-1}\\left(\\pm 0.206\\right) $$ , while that of normal teeth is about 3.69 mm - 1 ± 0.231 $$ 3.69\\ {\\mathrm{mm}}^{-1}\\ \\left(\\pm 0.231\\right) $$ . Attenuation coefficient of carious regions is 35% higher than that of normal teeth. Moreover, five classes of caries were qualified and classified based on the optical attenuation coefficient. Compared with the healthy teeth, there is a noticeable disparity in the attenuation coefficients of carious teeth, both on the surface and at the dentinoenamel junction. This study provides a method for accurate caries diagnosis, particularly in detection of early lesions and subtle structural changes.
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  • 文章类型: Journal Article
    目的:量化健康受试者和无或轻度糖尿病视网膜病变的糖尿病患者视网膜外层和脉络膜早期结构改变的存在,并建立测量的结构参数与视网膜敏感性之间的相关性。
    方法:总共,纳入来自2型糖尿病受试者的31只眼和来自健康受试者的29只眼。光学相干断层扫描用于测量视网膜外层和脉络膜,而微视野用于表征黄斑6毫米直径区域的视觉功能变化。在组间进行结构和功能变化的定量分析,并确定结构-功能相关性。
    结果:肌样和椭球区的厚度,糖尿病组的脉络膜和平均视网膜敏感性均明显低于对照组(P值均<0.05)。此外,脉络膜和外视网膜变薄与视网膜敏感性降低有关,尤其是在糖尿病患者中(r=0.377,P=0.048;r=0.401,P=0.034)。最终多元回归模型显示视网膜外厚度(ORT)(P=0.033),脉络膜厚度(P=0.003)和ORT与脉络膜厚度之间的相互作用(P=0.001)是视网膜敏感性的重要预测因素。
    结论:脉络膜和外视网膜变薄与视网膜敏感性降低显著相关,这表明外视网膜和脉络膜可能是潜在的影像学标志物,用于评估2型糖尿病患者的神经损害相关的视觉功能,没有或在早期的糖尿病视网膜病变。
    OBJECTIVE: To quantify the presence of early structural alterations in the outer retinal layer and choroid among healthy subjects and diabetic patients with no or mild diabetic retinopathy, and to establish the correlation between the measured structural parameters and retinal sensitivity.
    METHODS: In total, 31 eyes from subjects with type 2 diabetes and 29 eyes from healthy subjects were enrolled. Optical coherence tomography was used to measure outer retina layers and choroid, while microperimetry was used to characterize the changes of visual function in a 6-mm diameter area at macula. Quantitative analysis of structural and functional changes was performed between groups and the structure-function correlations were determined.
    RESULTS: The thickness of myoid and ellipsoid zone, choroid and the mean retinal sensitivity were significantly smaller in diabetic group than that in controls (all P values < 0.05). Besides, thinner choroid and outer retina was associated with the decreased retinal sensitivity,especially in diabetic patients (r = 0.377, P = 0.048; r = 0.401, P = 0.034; respectively). Final multiple regression models showed the outer retinal thickness (ORT) (P = 0.033), choroidal thickness (P = 0.003) and the interaction between ORT and choroidal thickness (P = 0.001) were significant predictors to retinal sensitivity.
    CONCLUSIONS: Thinning of choroid and outer retina were significantly correlated with reduced retinal sensitivity, which indicate outer retina and choroid might be potential imaging markers for evaluation of visual function related to neural impairment in type 2 diabetic patients without or in the early stage of diabetic retinopathy.
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  • 文章类型: Journal Article
    非ST段抬高型心肌梗死(NSTEMI)患者梗死相关动脉(IRA)完全闭塞(TO)的病变的确切特征仍不清楚。本研究采用光学相干断层扫描(OCT)研究有或没有IRATO的NSTEMI患者的病理特征,并探讨血栓类型与IRA闭塞状态之间的关系。这是一项单中心回顾性研究。将202例诊断为NSTEMI的患者分为两组:经皮冠状动脉介入治疗(PCI)前的心肌梗死溶栓(TIMI)流量为0级的患者(称为TO组,n=100)和那些TIMI流量等级1-3(称为非TO组,n=102)。基线特征,冠状动脉造影结果,并收集OCT结果。多因素logistic分析确定了NSTEMI患者TO的影响因素。根据心电图(ECG)的类型,将NSTEMI的类别进一步细分为两个亚组:ST段未偏移心肌梗死(STUMI)和ST段抑制心肌梗死(STdMI)。这种划分允许对NSTEMI病例进行更具体的分类。TO组的年龄较小,较高的男性代表,更多的吸烟者,降低高血压和脑血管病的发病率,左心室射血分数(LVEF)较低,和较高的肌酸激酶心肌带(CKMB)和肌酸激酶(CK)峰值水平。在TO组中,LCX是主要的爱尔兰共和军(52.0%),而在非TO组中,LAD是主要的IRA(45.1%)。与非TO组相比,OCT结果显示,红色血栓/混合血栓在TO组更为常见,同时白色血栓的发生率较低(p<0.001)。TO组表现出更高的STUMI患病率(p=0.001),而在非TO组中更常见的是STdmi(p=0.001)。NSTEMI表示为STUMI和STDMI不同的实体。IRA中的红色血栓/混合血栓通常表明心电图上有STUMI的闭塞性病变。白色血栓提示非闭塞性病变,心电图上有STdmi。
    The precise features of lesions in non-ST-segment elevation myocardial infarction (NSTEMI) patients with total occlusion (TO) of the infarct-related artery (IRA) are still unclear. This study employs optical coherence tomography (OCT) to investigate pathological features in NSTEMI patients with or without IRA TO and explores the relationship between thrombus types and IRA occlusive status. This was a single-center retrospective study. A total of 202 patients diagnosed with NSTEMI were divided into two groups: those with Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 before percutaneous coronary intervention (PCI) (referred to as the TO group, n = 100) and those TIMI flow grade 1-3 (referred to as the Non-TO group, n = 102). Baseline characteristics, coronary angiography findings, and OCT results were collected. Multivariate logistic analysis identified factors influencing TO in NSTEMI. The category of NSTEMI was further subdivided based on the type of electrocardiogram (ECG) into two subgroups: ST segment unoffset myocardial infarction (STUMI) and ST segment depression myocardial infarction (STDMI). This division allows for a more specific classification of NSTEMI cases. The TO group had a younger age, higher male representation, more smokers, lower hypertension and cerebrovascular disease incidence, lower left ventricular ejection fraction (LVEF), and higher creatine kinase myocardial band (CKMB) and creatine kinase (CK) peak levels. In the TO group, LCX served as the main IRA (52.0%), whereas in the Non-TO group, LAD was the predominant IRA (45.1%). Compared to the Non-TO group, OCT findings demonstrated that red thrombus/mixed thrombus was more common in the TO group, along with a lower occurrence of white thrombus (p < 0.001). The TO group exhibited a higher prevalence of STUMI (p = 0.001), whereas STDMI was more commonly observed in the Non-TO group (p = 0.001). NSTEMI presents as STUMI and STDMI distinct entities. Red thrombus/mixed thrombus in IRA often indicates occlusive lesions with STUMI on ECG. White thrombus suggests non-occlusive lesions with STDMI on ECG.
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  • 文章类型: Editorial
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