Atherosclerotic plaque rupture is responsible for the majority of acute coronary syndromes and myocardial infarctions. Intravascular ultrasound (IVUS) imaging is a widely available clinical technique providing real time cross-sectional images of the vessel wall and plaque morphometry. However, IVUS echo images have limited ability to predict the vulnerability of the plaque. The mechanical behavior of the plaque is consistent with its underlying components, suggesting that measurements of plaque mechanical response can be used to assess the likelihood of plaque rupture [1]. Arterial wall strain in response to luminal pressure change is such a measurable quantity. IVUS elastography has been developed to measure the radial strain through correlation analysis of the IVUS radiofrequency (RF) signal [2]. Due to the movements of IVUS catheter caused by cardiac motion and the nonlinearity of tissue deformation, reliable strain is obtained by elastography only when the tissue motion is aligned with the RF direction and the RF traces correspond to the same axial location. This is difficult to achieve in vivo. We have developed a strain estimation method based on IVUS image registration. This 2D processing method has the ability to overcome in-plane catheter movement and heterogeneous tissue deformation, thereby increasing its accuracy. Using retrospectively retrieved cardiac phase information, we propose a practical method to estimate cross-sectional coronary arterial wall strain distribution from clinically acquired images during a conventional IVUS procedure.

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