Ultrasound imaging of coronary atherosclerosis

Intra-coronary ultrasonography (ICV) is a technique for in vivo study of th e different layers of the arterial wall, the site of atherosclerosis. A qua litative analysis of the composition of the plaque can predict its potentia l evolutivity (chronic with slow progression or at risk of rupture and caus ing acute thrombosis) and its response to different types of angioplasty, w hich could eventually become and essential factor in the choice of appropri ate therapeutic strategy. Analysis of the results of B mode ultrasonic scan ning has provided correlations with the histological composition of the art erial wall, validating the method and opening up the field of tissue charac terisation which hitherto had been limited by the absence of sufficiently r eliable, accurate and reproducible quantitative parameters. Magnetic resonance imaging (MRI) is a complementary, non-invasive tool for tissue analysis because its sensitivity to the biophysical and biochemical properties of tissues which makes it a promising method of morphological an d functional imaging. Other methods of imaging atheromatous plaques include angioscopy and optic coherence tomography which have also contributed to t he improvement in our knowledge of atherosclerosis. These methods of imagin g which are slowly overcoming their limitations provide documents which res semble more and more the histological appearances. Intracoronary ultrasonography is the most promising method and raises hopes that one day we shall be able to predict the outcome and anticipate the ri sk of rupture of atherosclerotic plaques.