As a luminogram, coronary angiography provides a good

overview of the coronary artery tree. Using quantitative

coronary measurements, the degree of coronary obstruction

can be determined. The limitation of coronary angiography is

that it does not provide information on the arterial wall structure

and therefore cannot assess the extent of atherosclerosis.

Knowledge about adaptive coronary remodelling processes as

compensatory enlargement of the coronary artery has focused

diagnostic interest on the non-stenotic lesions of the coronary

tree. Intravascular ultrasound (IVUS) can reveal discrepancies

between the extent of coronary atherosclerosis and

angiography imaging by in vivo plaque imaging. Spectrum

analysis of IVUS-derived radiofrequency (RF) data enables a

more detailed analysis of plaque composition and morphology.

Preliminary in vitro studies correlated four histological plaque

components with a specific spectrum analysis of the RF data.

The different components (fibrous, fibrofatty, necrotic core and

dense calcium) are colour coded. Coronary tissue maps were

reconstructed from RF data using IVUS–Virtual Histology

(VH IVUS) software (Real-Time VH, Volcano Corporation,

Rancho Cordova, California, USA). VH IVUS has the potential

to detect high-risk lesions and can provide new insights into the

pathophysiology of coronary artery disease. VH IVUS allows

the differentiation of different lesion types based on information

derived from histopathology. The in vivo specific histological

analysis of coronary atherosclerosis may allow better

stratification of treatment of patients with coronary artery

disease.