Abstract
The arterial wall has three layers: intima, typically white (echodense); media, a thin black band; adventitia, a thick, white, onion-skin external layer. The lumen is black (echolucent). In normal vessels, the intima is very thin, thinner than the media. When one is looking at an IVUS image, the first step is to find the black band inside the arterial wall. This black band is the media; inside it are the intima and the lumen. IVUS identifies three types of plaques, i.e., three types of intima: Echolucent, soft intima; Echodense, fibrous intima; and Calcified intima. Several studies have tried to associate ischemia with a single minimal luminal area cutoff by IVUS. Since it uses light, optical coherence tomography (OCT) has a much higher resolution than ultrasound/IVUS, an almost microscopic resolution (10 micrometers with OCT vs. 150 micrometers with IVUS).
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