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class="vector-toc-link" href="#Disadvantages_versus_angiography"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Disadvantages versus angiography</span> </div> </a> <ul id="toc-Disadvantages_versus_angiography-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Comparison_versus_intravascular_optical_coherence_tomography" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Comparison_versus_intravascular_optical_coherence_tomography"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Comparison versus intravascular optical coherence tomography</span> </div> </a> <ul id="toc-Comparison_versus_intravascular_optical_coherence_tomography-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Method" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Method"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Method</span> </div> </a> <ul id="toc-Method-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Uses" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Uses"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Uses</span> </div> </a> <button aria-controls="toc-Uses-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Uses subsection</span> </button> <ul id="toc-Uses-sublist" class="vector-toc-list"> <li id="toc-Intravascular_ultrasound_in_the_coronary_anatomy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Intravascular_ultrasound_in_the_coronary_anatomy"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Intravascular ultrasound in the coronary anatomy</span> </div> </a> <ul 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داخل الأوعية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Intravaskul%C3%A4rer_Ultraschall" title="Intravaskulärer Ultraschall – German" lang="de" hreflang="de" data-title="Intravaskulärer Ultraschall" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/%C3%89chographie_endovasculaire" title="Échographie endovasculaire – French" lang="fr" hreflang="fr" data-title="Échographie endovasculaire" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Ecografia_intravascolare" title="Ecografia intravascolare – Italian" lang="it" hreflang="it" data-title="Ecografia intravascolare" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Ultrasonografia_wewn%C4%85trzwie%C5%84cowa" title="Ultrasonografia wewnątrzwieńcowa – Polish" lang="pl" hreflang="pl" data-title="Ultrasonografia wewnątrzwieńcowa" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Ecografia_intravascular" title="Ecografia intravascular – Portuguese" lang="pt" hreflang="pt" data-title="Ecografia intravascular" data-language-autonym="Português" data-language-local-name="Portuguese" 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.ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Medical_citations_needed plainlinks metadata ambox ambox-content" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/b/b4/Ambox_important.svg/40px-Ambox_important.svg.png" decoding="async" width="40" height="40" class="mw-file-element" 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Unsourced or poorly sourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>. <small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Intravascular+ultrasound%22">"Intravascular ultrasound"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Intravascular+ultrasound%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Intravascular+ultrasound%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Intravascular+ultrasound%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Intravascular+ultrasound%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Intravascular+ultrasound%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">November 2021</span>)</i></span></div></td><td class="mbox-imageright"><div class="mbox-image-div"><span typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/52px-Star_of_life.svg.png" decoding="async" width="52" height="50" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/77px-Star_of_life.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/103px-Star_of_life.svg.png 2x" data-file-width="198" data-file-height="192" /></span></span></div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Intravascular ultrasound</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=00.2&Submit=Search&action=search">00.2</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/OPS-301" title="OPS-301">OPS-301 code</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://www.icd-code.de/ops/code/3-05e.html">3-05e</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/007266.htm">007266</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q1671577" class="extiw" title="d:Q1671577">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Intravascular ultrasound</b> (<b>IVUS</b>) or <b>intravascular echocardiography</b> is a <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a> methodology using a specially designed <a href="/wiki/Catheter" title="Catheter">catheter</a> with a miniaturized <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> probe attached to the distal end of the catheter. The proximal end of the <a href="/wiki/Catheter" title="Catheter">catheter</a> is attached to computerized <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> equipment. It allows the application of <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> technology, such as <a href="/wiki/Piezoelectric_transducer" class="mw-redirect" title="Piezoelectric transducer">piezoelectric transducer</a> or <a href="/wiki/Capacitive_micromachined_ultrasonic_transducers" class="mw-redirect" title="Capacitive micromachined ultrasonic transducers">CMUT</a>, to see from inside <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessels</a> out through the surrounding <a href="/wiki/Blood" title="Blood">blood</a> column, visualizing the <a href="/wiki/Endothelium" title="Endothelium">endothelium</a> (inner wall) of <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessels</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Artery" title="Artery">arteries</a> of the <a href="/wiki/Heart" title="Heart">heart</a> (the <a href="/wiki/Coronary_circulation" title="Coronary circulation">coronary arteries</a>) are the most frequent imaging target for IVUS. IVUS is used in the coronary arteries to determine the amount of <a href="/wiki/Atheroma" title="Atheroma">atheromatous plaque</a> built up at any particular point in the epicardial coronary artery. Intravascular ultrasound provides a unique method to study the regression or progression of atherosclerotic lesions in vivo.<sup id="cite_ref-pmid11460831_2-0" class="reference"><a href="#cite_note-pmid11460831-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The progressive accumulation of plaque within the artery wall over decades leads to the development of unstable <a href="/wiki/Vulnerable_plaque" title="Vulnerable plaque">vulnerable plaque</a> which can detach as clots leading to strokes and heart attacks. IVUS is of use to determine both plaque volume within the wall of the artery and/or the degree of stenosis of the artery <a href="/wiki/Lumen_(anatomy)" title="Lumen (anatomy)">lumen</a>. It can be especially useful in situations in which <a href="/wiki/Angiography" title="Angiography">angiographic</a> imaging is considered unreliable; such as for the lumen of ostial lesions or where angiographic images do not visualize lumen segments adequately, such as regions with multiple overlapping arterial segments. It is also used to assess the effects of treatments of stenosis such as with hydraulic angioplasty expansion of the artery, with or without stents, and the results of medical therapy over time. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Advantages_over_angiography">Advantages over angiography</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=1" title="Edit section: Advantages over angiography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Arguably the most valuable use of IVUS is to visualize plaque, which cannot be seen by angiography. Over time this technique has evolved into an extremely useful research tool for modern invasive cardiology,<sup id="cite_ref-pmid9782590_3-0" class="reference"><a href="#cite_note-pmid9782590-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> and it has been increasingly used in research to better understand the behavior of the <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a> process in living people. </p><p>IVUS enables accurately visualizing not only the lumen of the coronary arteries but also the <a href="/wiki/Atheroma" title="Atheroma">atheroma</a> (membrane/cholesterol loaded white blood cells) "hidden" within the wall. IVUS has thus enabled advances in clinical research providing a more thorough perspective and better understanding. </p><p>In the early 1990s, IVUS research on the re-stenosis problem after <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a> lead to recognition that most of the re-stenosis problem (as visualized by an angiography examination) was not true re-stenosis. Instead it was simply a remodeling of the atheromatous plaque, which was still protruding into the lumen of the artery after completion of angioplasty; the stenosis only appearing to be reduced because blood and contrast could now flow around and through some of the plaque. The angiographic dye column appeared widened adequately; yet considerable plaque was within the newly widened lumen and the lumen remained partially obstructed. This recognition promoted more frequent use of <a href="/wiki/Stent" title="Stent">stents</a> to hold the plaque outward against the inner artery walls, out of the lumen. </p><p>Additionally, IVUS examinations, as they were done more frequently, served to reveal and confirm the autopsy research findings of the late 1980s, showing that atheromatous plaque tends to cause expansion of the internal elastic lamina, causing the degree of plaque burden to be greatly underestimated by angiography.<sup id="cite_ref-Glagov-1987_4-0" class="reference"><a href="#cite_note-Glagov-1987-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Angiography only reveals the edge of the atheroma that protrudes into the lumen.<sup id="cite_ref-Zarins-1988_5-0" class="reference"><a href="#cite_note-Zarins-1988-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:IVUS_of_CAD.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/IVUS_of_CAD.png/400px-IVUS_of_CAD.png" decoding="async" width="400" height="196" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/IVUS_of_CAD.png/600px-IVUS_of_CAD.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a5/IVUS_of_CAD.png/800px-IVUS_of_CAD.png 2x" data-file-width="1218" data-file-height="598" /></a><figcaption>Intravascular ultrasound image of a coronary artery (left), with color-coding on the right, delineating the lumen (yellow), external elastic membrane (blue) and the atherosclerotic plaque burden (green). The percentage stenosis is defined as the area of the lumen (yellow) divided by the area of the external elastic membrane (blue) times 100. As the plaque burden increases, the lumen size will decrease and the degree of stenosis will increase.</figcaption></figure><p>Perhaps the greatest contribution to understanding, so far, was achieved by <a href="/wiki/Clinical_trial" title="Clinical trial">clinical research trials</a> completed in the United States in the late 1990s, using combined angiography and IVUS examination, to study which coronary lesions most commonly result in a myocardial infarction.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The studies revealed that most myocardial infarctions occur at areas with extensive atheroma within the artery wall, however very little stenosis of the artery opening.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The range of lumen stenosis locations at which myocardial infarctions occurred ranged from areas of mild dilation all the way to areas of greater than 95% stenosis. However the average or typical stenosis at which myocardial infarctions occurred were found to be less than 50%,<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> describing plaques long considered insignificant by many. Only 14% of <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attacks</a> occurred at locations with 75% or more stenosis<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2007)">citation needed</span></a></i>]</sup>, the <i>severe</i> stenoses previously thought by many to present the greatest danger to the individual. This research has changed the primary focus for <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attack</a> prevention from <i>severe</i> <a href="/wiki/Stenosis" title="Stenosis">narrowing</a> to <a href="/wiki/Vulnerable_plaque" title="Vulnerable plaque">vulnerable plaque</a>. </p><p>Current clinical uses of IVUS technology include checking how to treat complex lesions before <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a> and checking how well an intracoronary stent has been deployed within a coronary artery after <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a>. If a stent is not expanded flush against the wall of the vessel, turbulent flow may occur between the stent and the wall of the vessel; some fear this might create a nidus for acute <a href="/wiki/Thrombosis" title="Thrombosis">thrombosis</a> of the artery. </p> <div class="mw-heading mw-heading2"><h2 id="Disadvantages_versus_angiography">Disadvantages versus angiography</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=2" title="Edit section: Disadvantages versus angiography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The primary disadvantages of IVUS being used routinely in a cardiac catheterization laboratory are its expense, the increase in the time of the procedure, and the fact that it is considered an interventional procedure, and should only be performed by angiographers that are trained in interventional cardiology techniques. In addition, there may be additional risk imposed by the use of the IVUS catheter. </p><p>The computerized IVUS <a href="/wiki/Echocardiogram" class="mw-redirect" title="Echocardiogram">echocardiographic</a> imaging systems list for $120,000, US, 2007 for a cart based system and ~$70,000 for an installed or integrated solution. The disposable catheters used to do each examination typically cost ~$600, US, 2007. In many hospitals, the IVUS system is placed as part of a bundle deal based on minimum disposable sales volumes. In other words, the cost of the console is paid for by rebates from other purchased products including IVUS catheters. Because no standard exists, IVUS catheters cannot be interchanged between different manufacturers. </p><p>Additionally, IVUS adds significant additional examination time and some increased risk to the patient beyond performing a standard diagnostic angiographic examination. This increase is significantly less when IVUS is part of a <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a>, since much of the setup is the same for the intervention as for the IVUS imaging. </p><p>IVUS continues to improve and some manufacturers have proposed building IVUS technology into <a href="/wiki/Angioplasty" title="Angioplasty">angioplasty</a> and <a href="/wiki/Stent" title="Stent">stent</a> balloon catheters, a potential major advance, but limited by complexity, cost and increased bulk of the catheters. </p> <div class="mw-heading mw-heading2"><h2 id="Comparison_versus_intravascular_optical_coherence_tomography">Comparison versus intravascular optical coherence tomography</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=3" title="Edit section: Comparison versus intravascular optical coherence tomography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Compared to IVUS, <a href="/wiki/Intravascular_Optical_Coherence_Tomography" class="mw-redirect" title="Intravascular Optical Coherence Tomography">intravascular OCT</a> offers an order of magnitude improved resolution for a better visualization of vessel lumen, tissue microstructure and devices (e.g., intracoronary stents).<sup id="cite_ref-BezerraCosta2009_9-0" class="reference"><a href="#cite_note-BezerraCosta2009-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> IVUS offers an improved imaging depth for the assessment of lipid or necrotic plaques, while intravascular OCT offers better penetration and enhanced imaging of calcific tissue. Intravascular OCT requires a short injection of contrast (e.g., 2 to 3 seconds) in a similar way to obtain an angiographic image. IVUS does not require a contrast injection as ultrasounds can penetrate through blood. </p> <div class="mw-heading mw-heading2"><h2 id="Method">Method</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=4" title="Edit section: Method"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To visualize an <a href="/wiki/Artery" title="Artery">artery</a> or <a href="/wiki/Vein" title="Vein">vein</a>, <a href="/wiki/Angiography" title="Angiography">angiographic</a> techniques are used and the physician positions the tip of a guidewire, usually 0.36 mm (0.014") diameter with a very soft and pliable tip and about 200 cm long. The physician steers the guidewire from outside the body, through angiography catheters and into the blood vessel branch to be imaged. </p><p>The ultrasound catheter tip is slid in over the guidewire and positioned, using <a href="/wiki/Angiography" title="Angiography">angiography</a> techniques so that the tip is at the farthest away position to be imaged. The sound waves are emitted from the catheter tip, are usually in the 20-40 MHz range, and the catheter also receives and conducts the return echo information out to the external computerized ultrasound equipment which constructs and displays a real time ultrasound image of a thin section of the blood vessel currently surrounding the catheter tip, usually displayed at 30 frames/second image. </p><p>The guide wire is kept stationary and the ultrasound catheter tip is slid backwards, usually under motorized control at a pullback speed of 0.5 mm/s. (The motorized pullback tends to be smoother than hand movement by the physician.) </p><p>The (a) blood vessel wall inner <a href="/wiki/Endothelium" title="Endothelium">lining</a>, (b) atheromatous disease within the wall and (c) connective tissues covering the outer surface of the blood vessel are <a href="/wiki/Echogenic" class="mw-redirect" title="Echogenic">echogenic</a>, i.e. they return echoes making them visible on the ultrasound display. </p><p>By contrast, the blood itself and the healthy muscular tissue portion of the blood vessel wall is relatively <a href="/w/index.php?title=Echolucent&action=edit&redlink=1" class="new" title="Echolucent (page does not exist)">echolucent</a>, just black circular spaces, in the images. </p><p>Heavy <a href="/wiki/Calcification" title="Calcification">calcium deposits</a> in the blood vessel wall both heavily reflect sound, i.e. are very echogenic, but are also distinguishable by shadowing. Heavy calcification blocks sound transmission beyond and so, in the echo images, are seen as both very bright areas but with black shadows behind (from the vantage point of the catheter tip emitting the ultrasound waves). </p> <div class="mw-heading mw-heading2"><h2 id="Uses">Uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=5" title="Edit section: Uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>IVUS, as outlined above, has been the best technology, so far, to demonstrate the anatomy of the <a href="/wiki/Artery" title="Artery">artery</a> wall in living animals and humans. It has led to an explosion of better understanding and research on both (a) the behavior of the <a href="/wiki/Atherosclerosis" title="Atherosclerosis">atherosclerosis</a> process and (b) the effects of different treatment strategies for changing the evolution of the atherosclerosis disease process. This has been important given that atherosclerosis is the single most frequent disease process for the greatest percentage of individuals living in first world countries. </p> <div class="mw-heading mw-heading3"><h3 id="Intravascular_ultrasound_in_the_coronary_anatomy">Intravascular ultrasound in the coronary anatomy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=6" title="Edit section: Intravascular ultrasound in the coronary anatomy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:IVUS-Tracing.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/8/8d/IVUS-Tracing.png/350px-IVUS-Tracing.png" decoding="async" width="350" height="282" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8d/IVUS-Tracing.png/525px-IVUS-Tracing.png 1.5x, //upload.wikimedia.org/wikipedia/en/8/8d/IVUS-Tracing.png 2x" data-file-width="543" data-file-height="438" /></a><figcaption>An IVUS image of the ostial <a href="/wiki/Left_coronary_artery" title="Left coronary artery">left main coronary artery</a> (left). The blue outline delineates the cross-sectional area of the lumen of the artery (A1 in the upper right corner), measuring 6.0 mm<sup>2</sup>. A two-dimensional mapping of the <a href="/wiki/Left_anterior_descending_coronary_artery" class="mw-redirect" title="Left anterior descending coronary artery">proximal LAD</a> and left main coronary arteries is shown on the right.</figcaption></figure> <p>While the routine use of IVUS during <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a> does not improve short term outcomes,<sup id="cite_ref-Schiele-1998_10-0" class="reference"><a href="#cite_note-Schiele-1998-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> there are a number of situations in which IVUS is of particular use in the treatment of <a href="/wiki/Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a> of the <a href="/wiki/Heart" title="Heart">heart</a>. In particular in cases when the degree of stenosis of a coronary artery is unclear, IVUS can directly quantify the percentage of stenosis and give insight into the anatomy of the plaque. </p><p>One particular use of IVUS in the coronary anatomy is in the quantification of left main disease in cases where routine coronary angiography gives equivocal results. Many studies in the past have shown that significant left main disease can increase <a href="/wiki/Death" title="Death">mortality</a>,<sup id="cite_ref-Abizaid-1999_11-0" class="reference"><a href="#cite_note-Abizaid-1999-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> and that intervention (either <a href="/wiki/Coronary_artery_bypass_graft" class="mw-redirect" title="Coronary artery bypass graft">coronary artery bypass graft surgery</a> or <a href="/wiki/Percutaneous_coronary_intervention" title="Percutaneous coronary intervention">percutaneous coronary intervention</a>) to reduce mortality is necessary when the left main stenosis is significant. </p><p>When using IVUS to determine whether an individual's left main disease is clinically significant, in terms of the desirability of physical intervention, the two most widely used parameters are the degree of stenosis and the minimal lumen area.<sup id="cite_ref-Safian-2002_12-0" class="reference"><a href="#cite_note-Safian-2002-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> A cross sectional area of ≤7 mm² in a symptomatic individual<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2007)">citation needed</span></a></i>]</sup> or ≤6 mm² in an asymptomatic individual<sup id="cite_ref-Jasti-2004_13-0" class="reference"><a href="#cite_note-Jasti-2004-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> is considered to be clinically significant and warrants intervention to improve one-year mortality. However, these exact cutoffs are up for debate and different cutoff cross-sectional areas may be used in practice depending on differing interpretations of the trial data. </p> <div class="mw-heading mw-heading3"><h3 id="Validating_the_efficacy_of_new_treatments">Validating the efficacy of new treatments</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=7" title="Edit section: Validating the efficacy of new treatments"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Because IVUS is widely available in coronary catheterization labs worldwide and can accurately quantify arterial <a href="/wiki/Atheromatous_plaque" class="mw-redirect" title="Atheromatous plaque">plaque</a>, especially within the coronary arteries, it is increasingly being used to evaluate newer and evolving strategies for the treatment of coronary artery disease, including the <a href="/wiki/Statin" title="Statin">statins</a><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> and other approaches.<sup id="cite_ref-Nissen-2002_15-0" class="reference"><a href="#cite_note-Nissen-2002-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Nissen-2003_16-0" class="reference"><a href="#cite_note-Nissen-2003-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=8" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Fractional_flow_reserve" title="Fractional flow reserve">Fractional flow reserve</a></li> <li><a href="/wiki/Intracoronary_Optical_Coherence_Tomography" class="mw-redirect" title="Intracoronary Optical Coherence Tomography">Intracoronary Optical Coherence Tomography</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intravascular_ultrasound&action=edit&section=9" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output 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(2006). <a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.295.13.jpc60002">"Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial"</a>. <i>JAMA: The Journal of the American Medical Association</i>. <b>295</b> (13): 1556–65. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.295.13.jpc60002">10.1001/jama.295.13.jpc60002</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16533939">16533939</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=JAMA%3A+The+Journal+of+the+American+Medical+Association&rft.atitle=Effect+of+very+high-intensity+statin+therapy+on+regression+of+coronary+atherosclerosis%3A+the+ASTEROID+trial&rft.volume=295&rft.issue=13&rft.pages=1556-65&rft.date=2006&rft_id=info%3Adoi%2F10.1001%2Fjama.295.13.jpc60002&rft_id=info%3Apmid%2F16533939&rft.aulast=Nissen&rft.aufirst=SE&rft.au=Nicholls%2C+SJ&rft.au=Sipahi%2C+I&rft.au=Libby%2C+P&rft.au=Raichlen%2C+JS&rft.au=Ballantyne%2C+CM&rft.au=Davignon%2C+J&rft.au=Erbel%2C+R&rft.au=Fruchart%2C+JC&rft.au=Tardif%2C+Jean-Claude&rft.au=Schoenhagen%2C+Paul&rft.au=Crowe%2C+Tim&rft.au=Cain%2C+Valerie&rft.au=Wolski%2C+Kathy&rft.au=Goormastic%2C+Marlene&rft.au=Tuzcu%2C+E.+Murat&rft.au=Asteroid+Investigators%2C+for+the&rft_id=https%3A%2F%2Fdoi.org%2F10.1001%252Fjama.295.13.jpc60002&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntravascular+ultrasound" class="Z3988"></span></span> </li> <li id="cite_note-Nissen-2002-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-Nissen-2002_15-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNissen_SE2002" class="citation journal cs1">Nissen SE (2002). 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id="cite_note-Nissen-2003-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-Nissen-2003_16-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNissenTsunodaTuzcuSchoenhagen2003" class="citation journal cs1">Nissen SE, Tsunoda T, Tuzcu EM, Schoenhagen P, Cooper CJ, Yasin M, Eaton GM, Lauer MA, Sheldon WS, Grines CL, Halpern S, Crowe T, Blankenship JC, Kerensky R (2003). <a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.290.17.2292">"Effect of Recombinant ApoA-I Milano on Coronary Atherosclerosis in Patients With Acute Coronary Syndromes"</a>. <i>JAMA</i>. <b>290</b> (17): 2292–2300. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.290.17.2292">10.1001/jama.290.17.2292</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14600188">14600188</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=JAMA&rft.atitle=Effect+of+Recombinant+ApoA-I+Milano+on+Coronary+Atherosclerosis+in+Patients+With+Acute+Coronary+Syndromes&rft.volume=290&rft.issue=17&rft.pages=2292-2300&rft.date=2003&rft_id=info%3Adoi%2F10.1001%2Fjama.290.17.2292&rft_id=info%3Apmid%2F14600188&rft.aulast=Nissen&rft.aufirst=SE&rft.au=Tsunoda%2C+T&rft.au=Tuzcu%2C+EM&rft.au=Schoenhagen%2C+P&rft.au=Cooper%2C+CJ&rft.au=Yasin%2C+M&rft.au=Eaton%2C+GM&rft.au=Lauer%2C+MA&rft.au=Sheldon%2C+WS&rft.au=Grines%2C+CL&rft.au=Halpern%2C+S&rft.au=Crowe%2C+T&rft.au=Blankenship%2C+JC&rft.au=Kerensky%2C+R&rft_id=https%3A%2F%2Fdoi.org%2F10.1001%252Fjama.290.17.2292&rfr_id=info%3Asid%2Fen.wikipedia.org%3AIntravascular+ultrasound" 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style="width:1%"><a href="/wiki/X-ray" title="X-ray">X-ray</a>/<br /><a href="/wiki/Radiography" title="Radiography">radiography</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Projectional_radiography" title="Projectional radiography">2D</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pneumoencephalography" title="Pneumoencephalography">Pneumoencephalography</a></li> <li><a href="/wiki/Dental_radiography" title="Dental radiography">Dental radiography</a></li> <li><a href="/wiki/Sialography" title="Sialography">Sialography</a></li> <li><a href="/wiki/Myelography" title="Myelography">Myelography</a></li> <li><a href="/wiki/Chest_radiograph" title="Chest radiograph">CXR</a> <ul><li><a href="/wiki/Bronchography" title="Bronchography">Bronchography</a></li></ul></li> <li><a href="/wiki/Abdominal_x-ray" title="Abdominal x-ray">AXR</a></li> <li><a href="/wiki/Abdominal_x-ray" title="Abdominal x-ray">KUB</a></li> <li><a href="/wiki/Dual-energy_X-ray_absorptiometry" title="Dual-energy X-ray absorptiometry">DXA</a>/<a href="/wiki/Digital_X-ray_radiogrammetry" title="Digital X-ray radiogrammetry">DXR</a></li> <li><a href="/wiki/Upper_gastrointestinal_series" title="Upper gastrointestinal series">Upper gastrointestinal series</a>/<a href="/wiki/Small-bowel_follow-through" class="mw-redirect" title="Small-bowel follow-through">Small-bowel follow-through</a>/<a href="/wiki/Lower_gastrointestinal_series" title="Lower gastrointestinal series">Lower gastrointestinal series</a></li> <li><a href="/wiki/Cholangiography" title="Cholangiography">Cholangiography</a>/<a href="/wiki/Cholecystography" title="Cholecystography">Cholecystography</a></li> <li><a href="/wiki/Mammography" title="Mammography">Mammography</a></li> <li><a href="/wiki/Pyelogram" title="Pyelogram">Pyelogram</a></li> <li><a href="/wiki/Cystography" title="Cystography">Cystography</a></li> <li><a href="/wiki/Arthrogram" title="Arthrogram">Arthrogram</a></li> <li><a href="/wiki/Hysterosalpingography" title="Hysterosalpingography">Hysterosalpingography</a></li> <li><a href="/wiki/Skeletal_survey" title="Skeletal survey">Skeletal survey</a></li> <li><a href="/wiki/Angiography" title="Angiography">Angiography</a> <ul><li><a href="/wiki/Angiocardiography" class="mw-redirect" title="Angiocardiography">Angiocardiography</a></li> <li><a href="/wiki/Aortography" title="Aortography">Aortography</a></li></ul></li> <li><a href="/wiki/Venography" title="Venography">Venography</a></li> <li><a href="/wiki/Lymphogram" title="Lymphogram">Lymphogram</a></li> <li><a href="/wiki/Orbital_x-ray" title="Orbital x-ray">Orbital x-ray</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/CT_scan" title="CT scan">CT scan</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;font-weight:normal;">Techniques:</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Operation_of_computed_tomography" title="Operation of computed tomography">General operation</a></li> <li><a href="/wiki/Quantitative_computed_tomography" title="Quantitative computed tomography">Quantitative</a></li> <li><a href="/wiki/High-resolution_computed_tomography" title="High-resolution computed tomography">High-resolution</a></li> <li><a href="/wiki/X-ray_microtomography" title="X-ray microtomography">X-ray microtomography</a></li> <li><a href="/wiki/Electron_beam_computed_tomography" title="Electron beam computed tomography">Electron beam</a></li> <li><a href="/wiki/Cone_beam_computed_tomography" title="Cone beam computed tomography">Cone beam</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight:normal;">Targets</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Heart <ul><li><a href="/wiki/Coronary_CT_calcium_scan" title="Coronary CT calcium scan">calcium scan</a></li> <li><a href="/wiki/Coronary_CT_angiography" title="Coronary CT angiography">angiography</a></li></ul></li> <li><a href="/wiki/Computed_tomography_of_the_abdomen_and_pelvis" title="Computed tomography of the abdomen and pelvis">Abdominal and pelvis</a> <ul><li><a href="/wiki/Virtual_colonoscopy" title="Virtual colonoscopy">Virtual colonoscopy</a></li></ul></li> <li><a href="/wiki/Computed_tomography_angiography" title="Computed tomography angiography">Angiography</a> <ul><li><a href="/wiki/Coronary_CT_angiography" title="Coronary CT angiography">Coronary</a></li> <li><a href="/wiki/CT_pulmonary_angiogram" title="CT pulmonary angiogram">Pulmonary</a></li></ul></li> <li><a href="/wiki/Computed_tomography_of_the_head" title="Computed tomography of the head">Head</a></li> <li><a href="/wiki/Computed_tomography_of_the_thyroid" title="Computed tomography of the thyroid">Thyroid</a></li> <li><a href="/wiki/Whole_body_imaging" title="Whole body imaging">Whole body imaging</a> <ul><li><a href="/wiki/Full-body_CT_scan" title="Full-body CT scan">Full-body CT scan</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fluoroscopy" title="Fluoroscopy">Fluoroscopy</a></li> <li><a href="/wiki/Panoramic_radiograph" title="Panoramic radiograph">Dental panoramic radiography</a></li> <li><a href="/wiki/X-ray_motion_analysis" title="X-ray motion analysis">X-ray motion analysis</a></li> <li><a href="/wiki/Hounsfield_scale" title="Hounsfield scale">Hounsfield scale</a></li> <li><a href="/wiki/Radiodensity" title="Radiodensity">Radiodensity</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">MRI</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Magnetic_resonance_imaging_of_the_brain" title="Magnetic resonance imaging of the brain">Brain</a> <ul><li><a href="/wiki/Functional_magnetic_resonance_imaging" title="Functional magnetic resonance imaging">functional</a></li></ul></li> <li><a href="/wiki/Magnetic_resonance_neurography" title="Magnetic resonance neurography">Neurography</a></li> <li><a href="/wiki/Cardiac_magnetic_resonance_imaging" title="Cardiac magnetic resonance imaging">Cardiac</a> <ul><li><a href="/wiki/Cardiac_magnetic_resonance_imaging_perfusion" title="Cardiac magnetic resonance imaging perfusion">perfusion</a></li></ul></li> <li><a href="/wiki/Magnetic_resonance_angiography" title="Magnetic resonance angiography">Angiography</a></li> <li><a href="/wiki/Magnetic_resonance_cholangiopancreatography" title="Magnetic resonance cholangiopancreatography">Cholangiopancreatography (MRCP)</a></li> <li><a href="/wiki/Breast_MRI" title="Breast MRI">Breast</a></li> <li><a href="/wiki/MRI_sequence" class="mw-redirect" title="MRI sequence">Sequences</a> <ul><li><a href="/wiki/Diffusion_MRI" class="mw-redirect" title="Diffusion MRI">diffusion</a></li> <li><a href="/wiki/Perfusion_MRI" title="Perfusion MRI">restriction</a></li> <li><a href="/wiki/Tractography" title="Tractography">Tractography</a></li></ul></li> <li><a href="/wiki/Synthetic_MRI" title="Synthetic MRI">Synthetic MRI</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_ultrasound" title="Medical ultrasound">Ultrasound</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Techniques <ul><li><a href="/wiki/Doppler_ultrasonography" title="Doppler ultrasonography">doppler</a></li> <li><a href="/wiki/Contrast-enhanced_ultrasound" title="Contrast-enhanced ultrasound">contrast-enhanced</a></li> <li><a href="/wiki/3D_ultrasound" title="3D ultrasound">3D</a></li> <li><a href="/wiki/Endoscopic_ultrasound" title="Endoscopic ultrasound">endoscopic</a></li> <li><a href="/wiki/Duplex_ultrasonography" class="mw-redirect" title="Duplex ultrasonography">duplex</a></li></ul></li> <li><a href="/wiki/Echocardiography" title="Echocardiography">Echocardiography</a> <ul><li><a href="/wiki/Doppler_echocardiography" title="Doppler echocardiography">Doppler echocardiography</a></li> <li><a href="/wiki/Transthoracic_echocardiogram" title="Transthoracic echocardiogram">TTE</a></li> <li><a href="/wiki/Transesophageal_echocardiogram" title="Transesophageal echocardiogram">TEE</a></li> <li><a href="/wiki/Intracardiac_echocardiogram" title="Intracardiac echocardiogram">ICE</a></li></ul></li> <li><a href="/wiki/Transcranial_Doppler" title="Transcranial Doppler">Transcranial Doppler</a></li> <li><a class="mw-selflink selflink">Intravascular</a></li> <li><a href="/wiki/Gynecologic_ultrasonography" title="Gynecologic ultrasonography">Gynecologic</a></li> <li><a href="/wiki/Obstetric_ultrasonography" title="Obstetric ultrasonography">Obstetric</a></li> <li><a href="/wiki/Echoencephalography" title="Echoencephalography">Echoencephalography</a></li> <li><a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">Abdominal ultrasonography</a> <ul><li><a href="/wiki/Renal_ultrasonography" title="Renal ultrasonography">renal</a></li> <li><a href="/wiki/Renal_tract_ultrasound" class="mw-redirect" title="Renal tract ultrasound">renal tract</a></li></ul></li> <li><a href="/wiki/Transrectal_ultrasonography" title="Transrectal ultrasonography">Rectal</a></li> <li><a href="/wiki/Breast_ultrasound" title="Breast ultrasound">Breast</a></li> <li><a href="/wiki/Scrotal_ultrasound" title="Scrotal ultrasound">Scrotal</a></li> <li><a href="/wiki/Carotid_ultrasonography" title="Carotid ultrasonography">Carotid</a></li> <li><a href="/wiki/Emergency_ultrasound" title="Emergency ultrasound">Emergency ultrasound</a> <ul><li><a href="/wiki/Focused_assessment_with_sonography_for_trauma" title="Focused assessment with sonography for trauma">FAST</a></li> <li><a href="/wiki/Pre-hospital_ultrasound" title="Pre-hospital ultrasound">pre-hospital</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nuclear_medicine#Diagnostic_medical_imaging" title="Nuclear medicine">Radionuclide</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">2D/<a href="/wiki/Scintigraphy" title="Scintigraphy">scintigraphy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholescintigraphy" title="Cholescintigraphy">Cholescintigraphy</a></li> <li><a href="/wiki/Scintimammography" class="mw-redirect" title="Scintimammography">Scintimammography</a></li> <li><a href="/wiki/Ventilation/perfusion_scan" title="Ventilation/perfusion scan">Ventilation/perfusion scan</a></li> <li><a href="/wiki/Radionuclide_ventriculography" class="mw-redirect" title="Radionuclide ventriculography">Radionuclide ventriculography</a></li> <li><a href="/wiki/Radionuclide_angiography" title="Radionuclide angiography">Radionuclide angiography</a></li> <li><a href="/wiki/Radioisotope_renography" title="Radioisotope renography">Radioisotope renography</a></li> <li><a href="/wiki/Sestamibi_parathyroid_scintigraphy" class="mw-redirect" title="Sestamibi parathyroid scintigraphy">Sestamibi parathyroid scintigraphy</a></li> <li><a href="/wiki/Radioactive_iodine_uptake_test" title="Radioactive iodine uptake test">Radioactive iodine uptake test</a></li> <li><a href="/wiki/Bone_scintigraphy" title="Bone scintigraphy">Bone scintigraphy</a></li> <li><a href="/wiki/Immunoscintigraphy" title="Immunoscintigraphy">Immunoscintigraphy</a></li> <li><a href="/wiki/Dacryoscintigraphy" title="Dacryoscintigraphy">Dacryoscintigraphy</a></li> <li><a href="/wiki/DMSA_scan" title="DMSA scan">DMSA scan</a></li> <li><a href="/wiki/Gastric_emptying_study" title="Gastric emptying study">Gastric emptying study</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight:normal;">Full body:</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Octreotide_scan" title="Octreotide scan">Octreotide scan</a></li> <li><a href="/wiki/Gallium_scan" title="Gallium scan">Gallium-67 scan</a></li> <li><a href="/wiki/Gallium_scan" title="Gallium scan">Ga-68-DOTATOC</a></li> <li><a href="/wiki/Indium-111_WBC_scan" title="Indium-111 WBC scan">Indium-111 WBC scan</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">3D/<a href="/wiki/Emission_computed_tomography" title="Emission computed tomography">ECT</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;font-weight:normal;"><a href="/wiki/Single-photon_emission_computed_tomography" title="Single-photon emission computed tomography">SPECT</a> (<a href="/wiki/Gamma_ray" title="Gamma ray">gamma ray</a>):</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Myocardial_perfusion_imaging" title="Myocardial perfusion imaging">Myocardial perfusion imaging</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;font-weight:normal;"><a href="/wiki/Positron_emission_tomography" title="Positron emission tomography">PET</a> (<a href="/wiki/Positron" title="Positron">positron</a>):</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_positron_emission_tomography" title="Brain positron emission tomography">Brain PET</a></li> <li><a href="/wiki/Cardiac_PET" title="Cardiac PET">Cardiac PET</a></li> <li><a href="/wiki/Positron_emission_mammography" title="Positron emission mammography">PET mammography</a></li> <li><a href="/wiki/PET-CT" title="PET-CT">PET-CT</a></li> <li><a href="/wiki/PET-MRI" title="PET-MRI">PET-MRI</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_optical_imaging" title="Medical optical imaging">Optical</a>/<a href="/wiki/Laser" title="Laser">Laser</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Optical_tomography" title="Optical tomography">Optical tomography</a> <ul><li><a href="/wiki/Optical_coherence_tomography" title="Optical coherence tomography">Optical coherence tomography</a></li></ul></li> <li><a href="/wiki/Confocal_microscopy" title="Confocal microscopy">Confocal microscopy</a></li> <li><a href="/wiki/Endomicroscopy" title="Endomicroscopy">Endomicroscopy</a></li> <li><a href="/wiki/Orthogonal_polarization_spectral_imaging" title="Orthogonal polarization spectral imaging">Orthogonal polarization spectral imaging</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thermography" title="Thermography">Thermography</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Non-contact_thermography" title="Non-contact thermography">Non-contact thermography</a></li> <li><a href="/w/index.php?title=Contact_thermography&action=edit&redlink=1" class="new" title="Contact thermography (page does not exist)">Contact thermography</a></li> <li><a href="/wiki/Dynamic_angiothermography" title="Dynamic angiothermography">Dynamic angiothermography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Target conditions</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_stroke_imaging" class="mw-redirect" title="Acute stroke imaging">Acute stroke</a></li> <li><a href="/wiki/Medical_imaging_in_pregnancy" title="Medical imaging in pregnancy">Pregnancy</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Medical_imaging" title="Category:Medical imaging">Category</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Vascular_surgery" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Vascular_procedures" title="Template:Vascular procedures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Vascular_procedures" title="Template talk:Vascular procedures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Vascular_procedures" title="Special:EditPage/Template:Vascular procedures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Vascular_surgery" style="font-size:114%;margin:0 4em"><a href="/wiki/Vascular_surgery" title="Vascular surgery">Vascular surgery</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vascular_surgery" title="Vascular surgery">Vascular</a> and <br /><a href="/wiki/Interventional_radiology#Vascular" title="Interventional radiology">Endovascular surgery</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Arterial_disease" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peripheral_artery_disease" title="Peripheral artery disease">Arterial disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vascular_bypass" title="Vascular bypass">Vascular bypass</a></li> <li><a href="/wiki/Angioplasty" title="Angioplasty">Angioplasty</a></li> <li><a href="/wiki/Atherectomy" title="Atherectomy">Atherectomy</a></li> <li><a href="/wiki/Endarterectomy" title="Endarterectomy">Endarterectomy</a> <ul><li><a href="/wiki/Carotid_endarterectomy" title="Carotid endarterectomy">Carotid endarterectomy</a></li></ul></li> <li><a href="/wiki/Stenting" class="mw-redirect" title="Stenting">Stenting</a> <ul><li><a href="/wiki/Carotid_stenting" title="Carotid stenting">Carotid stenting</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Varicose_veins" title="Varicose veins">Venous disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ambulatory_phlebectomy" title="Ambulatory phlebectomy">Ambulatory phlebectomy</a></li> <li><a href="/wiki/Laser_surgery" title="Laser surgery">Laser surgery</a></li> <li><a href="/wiki/Sclerotherapy" title="Sclerotherapy">Sclerotherapy</a></li> <li><a href="/wiki/Vein_stripping" title="Vein stripping">Vein stripping</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Artery" title="Artery">Arterial</a> and <a href="/wiki/Vein" title="Vein">venous</a> access</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Venous_cutdown" title="Venous cutdown">Venous cutdown</a></li> <li><a href="/wiki/Arteriotomy" title="Arteriotomy">Arteriotomy</a></li> <li><a href="/wiki/Phlebotomy" title="Phlebotomy">Phlebotomy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Aortic_aneurysm" title="Aortic aneurysm">Aortic aneurysm</a> / <a href="/wiki/Aortic_dissection" title="Aortic dissection">dissection</a>:</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Endovascular_aneurysm_repair" title="Endovascular aneurysm repair">Endovascular aneurysm repair</a></li> <li><a href="/wiki/Open_aortic_surgery" title="Open aortic surgery">Open aortic surgery</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cardiopulmonary_bypass" title="Cardiopulmonary bypass">Cardiopulmonary bypass</a></li> <li><a href="/wiki/Cardioplegia" title="Cardioplegia">Cardioplegia</a></li> <li><a href="/wiki/Isolated_organ_perfusion_technique" title="Isolated organ perfusion technique">Isolated organ perfusion technique</a> <ul><li><a href="/wiki/Extracorporeal_membrane_oxygenation" title="Extracorporeal membrane oxygenation">Extracorporeal membrane oxygenation</a></li></ul></li> <li><a href="/wiki/Vascular_access" title="Vascular access">Vascular access</a></li> <li><a href="/wiki/Revascularization" title="Revascularization">Revascularization</a></li> <li><a href="/wiki/First_rib_resection" title="First rib resection">First rib resection</a></li> <li><a href="/wiki/Seldinger_technique" title="Seldinger technique">Seldinger technique</a></li> <li><a href="/wiki/Vascular_snare" title="Vascular snare">Vascular snare</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Angiography" title="Angiography">Angiography</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Digital_subtraction_angiography" title="Digital subtraction angiography">Digital subtraction angiography</a> <ul><li><a href="/wiki/Cerebral_angiography" title="Cerebral angiography">Cerebral angiography</a></li> <li><a href="/wiki/Aortography" title="Aortography">Aortography</a></li> <li><a href="/wiki/Fluorescein_angiography" title="Fluorescein angiography">Fluorescein angiography</a></li> <li><a href="/wiki/Radionuclide_angiography" title="Radionuclide angiography">Radionuclide angiography</a></li> <li><a href="/wiki/Magnetic_resonance_angiography" title="Magnetic resonance angiography">Magnetic resonance angiography</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Venography" title="Venography">Venography</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Portography" title="Portography">Portography</a></li> <li><a href="/wiki/Impedance_phlebography" class="mw-redirect" title="Impedance phlebography">Impedance phlebography</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Ultrasound</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Intravascular ultrasound</a></li> <li><a href="/wiki/Carotid_ultrasonography" title="Carotid ultrasonography">Carotid ultrasonography</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other diagnostic</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Angioscopy" title="Angioscopy">Angioscopy</a></li> <li><a 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