Detecting thermal discrepancies in vessel walls

Description: TECHNICAL FIELD [Detailed description of the invention]

Detection of temperature difference in pipe wall Cross-reference of related patent applications This patent application was filed on September 20, 1995, "Temperature difference in blood vessels. Catheters and Methods Detecting Thermal Discr epancles in Blood Vessels) , United States Code, Vol. 35, 111 Claiming the benefit of Preliminary Application No. 60 / 004,061 under (b). Background of the invention The invention was made by the National Heart Lung and Blood Institute. Conducted with government support under the research grant 91HL07 given by It gives the federal government certain rights to the invention. Also open here The invention shown has been made in the study of contracts with the National Aeronautics and Space Administration (NASA). The 1958 US Aerospace Ordinance, Paragraph 305, Public Law 85-5 It follows 68 (72 Stat.435; United States Code Vol. 42, 2457). A. Field of invention The present invention is based on temperature difference sensing, more specifically a temperature probe or camera, Medical diagnosis of arterial disease by infrared sensing using a device such as a catheter And treatment. More specifically, the present invention provides warmth in catheters and arterial walls. It provides the use of catheters for arterial diseases that can be detected by degree. B. Description of conventional technology Problems in diagnosis <Plaque physiology> Coronary artery disease due to atherosclerosis is a major cause of death in industrialized countries It has become. Atherosclerosis plaque is the thickened part of the arterial wall. In general, dozens of atherosclerotic patients die from coronary artery disease Has plaque plaque. However, most of the myocardial infarctions, cardiac arrests and strokes In fact, one of these disorders ruptures, dehiscences, or develops ulcers. It just flirts. This rupture, dehiscence, or ulcer causes the inside of the artery A large blood clot (blood clot) is formed. A blood clot completes the flow of blood in an artery It blocks and damages the heart and brain. Main prognosis and diagnosis for cardiologists The dilemma is how to predict which plaque is likely to burst. That is. Most ruptured plaques are large poohs of cholesterol or necrotic tissue debris Characterized by a thin fiber cap that is significantly infiltrated with le and macrophages .. Plaques that cells release matrix-digesting enzymes It is believed to contribute to the rupture. Other blood clots are not ruptured but inflamed Found on the surface of the raised plaque. Inflammation in arterial plaque is a series of biochemical and mechanical changes in the arterial wall Is the result of. Thickening of plaque or arterial wall causes cholesterol accumulation and smoothing Proliferation of muscle cells, secretion of collagen cell stroma by cells, accumulation of macrophages, And finally with the consequences of bleeding, blood clots and calcification Occurs. The majority of opinion theory is that endothelial cell stimulation or biochemical damage As a result of this, atherosclerotic plaques occur. Endothelial cells that line the inside of blood vessels prevent the improper formation of blood clotting and its It suppresses the contraction and proliferation of the underlying smooth muscle cells. Most researchers lose endothelial cells Atherosclerosis puller when injured or dysfunctional I think that it will occur. Endothelial cell dysfunction is generally caused by cigarette smoke Wounds, high serum cholesterol (especially oxidized low density lipoproteins), (eg tubes) Changes in blood circulation (seen at bifurcations, etc.), certain viruses (herpes simplex) Viruses (viruses and cytomegalovirus) or bacteria (eg chlamydia), high Blood pressure, certain hormonal factors in serum (angiotensin II, norepinephrine) (Including), and caused by other factors that are not yet known. Against endothelial cells As a result of these gradual injuries, atherosclerotic plaques have been present for many years. It grows slowly. But today, when a plaque bursts, the plaque It is well documented to grow rapidly. When a plaque ruptures, bleeding occurs through a dehiscence where the surface of the plaque touches the bloodstream. It flows into the plaque. Blood is rapid when it comes in contact with plaque collagen and lipids Coagulates (forms a blood clot). This blood clot grows and completely or partially fills the blood vessels Close. In the latter case, new blood clots are generally taken into the plaque wall and Form larger plaques. <Plaque at risk of rupture> 60% to 70% of fatal myocardial infarctions are due to plaque rupture, and Monocytes-Macrophages degrade and weaken the upper fiber caps Metalloprotectors Releases ze (eg, collagenase, stromelysin) Considerable evidence has shown that the release contributes to the rupture. Outside Van der Wal, Circulation 89 : 36-44 (1994); Outside Nikkari, Circulation 92: 1393-1398 (19) 95); Outside Falk, Circulation 92: 2033-20335 (1995); Shah Outside (Shah), Circulation 244 (1995); Outside Davies, Brite Issue Heart Journal (Br Heart J) 53: 363-373 (1985); Constant Constantines, Journal Ateloscler Research (J Athe) roscler Res) 6: 1-17 (1966). In the other 25% to 30% of fatal infarctions Larks do not rupture and the endothelium underneath the thrombus is dependent on mononuclear cells or inflammatory cells To replace. Van der Wal et al., Circulation 89: 36-44; Farr Farb et al., Circulation 92: 1701-1709 (1995). These cells are moving Reacts to and exacerbates endometrial damage, promoting thrombosis and vasoconstriction .. Outside Baju, Circulation 89: 503-505 (1994). Unfortunately, both plaque rupture and plaque royal fern can be predicted by clinical means. I can't. Soluble markers (P-selectin, von Willebrand fa Kuta (von Willebrand factor), angiotensin converting enzyme, C-reactive tampa Ku, D Daima; Outside Ikeda, Circulation 92: 1693-1696 (1995); Me Outside of Merllnl, Circulation 90: 61-8 (1994); Outside of Berk , American Journal Cardiol 65: 168-172 (1990) ), And in patients with unstable angina with activated circulatory inflammatory cells However, it is still unclear whether these substances predict infarction or death. I don't know. Outside Mazzone, Circulation 88: 358-363 (1993) .. However, the presence of these substances cannot be used to locate the lesions involved. Is known. Low-shear regions facing flow bifurcations are more likely to cause atherosclerosis Easy (outside Ku, Arterioscerosis 5: 292-302 (1985) )) However, patients with acute myocardial infarction or sudden cardiac death may have no signs until then Many, let alone no signs on angiography. Outside Farb, Circulation 92 : 1701-1709 (1995). Irregular plaque shape, but less sensitive, according to some angiographic data , It has been found to be a fairly characteristic indicator of thrombus. Outside Kaski, Circulation 92: 2058-2065 (1995). These stenosis leads to complete obstruction proceed. Mild stenosis, on the other hand, progresses in the same way, leading to complete obstruction. Is few. Outside Aldeman, Journal American Cole Ka -Dior (J Am Coll Cardiol) 22: 1141-1154 (1993). But hemodynamically Non-serious stenosis is more numerous than severe stenosis and does not trigger concomitant growth Therefore, most of the myocardial infarctions are actually caused by sudden occlusion. To. Outside Ambrose, Journal American Cole Cardio J Am Coll Cardiol 12: 56-62; Outside Little, Circulation 78: 1157-1166 (1988). Furthermore, in autopsy, it is considered that stenosis with a diameter of 50% or less has occurred. Significant obstruction of the resulting ruptured or ulcerated plaque A blood clot is found. Outside Shah, Circulation 244 (1995). Such stenosis Rarely develops angina or is positive on a treadmill test. (Actually Patients dying from myocardial infarction have trivascular disease or severe left ventricular dysfunction Not) Outside Farb, Circulation 92: 1701-1709 (1995). Surface contour is uniform for most plaques that cause stenosis of 50% or less However, the deep structure is very variable and the plaque dimensions are also stenotic. There is no direct correlation with the degree. Outside Pasterkamp, Circulation Yong 91: 1444-1449 (1995); Man and Davies, Circulation 94: 928- 931 (1996). Determine the ability to identify rupturing plaques using internal coronary ultrasound Several studies have been done so far. (1) Angiography of the coronary artery Underestimate the degree of atherosclerosis, (2) Echo density is high The place usually shows a dense fibrous structure, (3) the echo density is low. Is characteristic of bleeding, blood clots, or cholesterol, (4) shadows are calcified It is known to show clothes. Outside Yock, Cardio 11-1 4 (1994); Outside McPerhson, N Engl J Med) 316: 304-309 (1987). However, recent studies have shown that current intravascular supersonic sounds Wave technology cannot distinguish between stable and unstable plaques I know that. Outside De Feyter, Circulation 92: 1 408-1413 (1995). The process of rupture is not fully understood. However, the most fragile plastic The coke has a thin collagen cap (fibrous scar tissue) and a lower puller It is known that it has a physically weak part in it. Inflamed surface Alternatively, it has a high density of activated macrophages and is covered with a thin cap. It is known that plaque is at risk of blood clots. Outside van der Wal, Sa -Curation 89: 36-44 (1994); Outside Shah, Circulation 244 (1995); Outside Davies, British Heart Journal 53: 363-373 (1985); Fa -Outside, Circulation 92: 1701-1709 (1995); Outside Van Damme, Cardiovasc Pathol 3: 9-17 (1994). These Where the cholesterol pool contacts the more cytoplasmic and fibrous part of the plaque It is thought to be located at the junction (according to model studies and pathological analysis). What). In general, heat-generating macrophages (inflammatory cells) are these binding sites. Seen in. These inflammatory cells are fermented that degrade collagen and other components of the extracellular matrix. Elementary These cells are important for the process of rupture or dehiscence because they release Is believed to be. <Transplant Vasculopathy> Inflammation is initiated by the attack of host T lymphocytes on the endothelial cells of the transplanted donor It also plays an important role in the rejection of transplanted organs, which is a whole process. Yeu ng) Outside, J. Heart Lung Transp lant) 14: S2l5-220 (1995); Outside Pucci, Journal Heart Transp Rand (J. Heart Transplant) 9: 339-45 (1990); Outside Crisp, Jana Le Hart Lang Transplant 13: 1381-1392 (1994). Inflammatory cells and flat Recretement and proliferation of myocytes are fever processes and stress tests, It can be detected before detecting vascular stenosis by ultrasound or angiography. Jo Outside Johnson, J.Am.Coll.Cardiol.17: 449-57 (191); Saint Gore ( St. Goar) Outside, Circulation 85: 979-987 (1992). "Non-self" of donor organs In addition to the host attack of the antigen, many transplanted tissues are also febrile events. Causes cytomegalovirus infection. Gratin (Gr attan) Outside, JAMA 261: 3561-3566 (1989). These things in transplant physiology are: It is a situation worth following in patients recovering from such surgery. <Restenosis> Another significant problem in heart disease is restenosis. What is restenosis (due to plaque) Single or multiple intervention techniques to relieve the original stenosis The arteries that have been treated are narrowed again. Balloon angioplasty for these techniques , Ateletatomy (cutting or cutting of plaque) and laser angioplasty. Balloon angioplasty of coronary arteries is an important advance in treatment and is hemodynamically important Performed for large coronary stenosis (70% to 99% of the cross-sectional diameter of the vessel) , The success rate is 90%. However, restenosis develops in blood vessels in about 40% of patients. It will be born and most of the therapeutic effect obtained by this surgery will be lost. Therefore, For cardiologists who cannot be easily resolved by conventional equipment or methods Another major dilemma of diagnosis and prognosis is which patients develop restenosis. To predict. Restenosis is caused by angioplasty or plaque resection by atherectomy to remove the arterial wall. It can occur when damaged. Due to damage to the blood vessel wall, at that location Smooth muscle cells in the cell proliferate and secrete extracellular matrix, which again narrows the arteries. Become. Both cell proliferation and secretion are fever (heat-generating) processes. further , Concentration of macrophages in blood vessels is associated with the risk of restenosis. Many factors have been reported to predict which patients will develop restenosis. However, many of these studies are in conflict with each other and are great for predicting the restenosis process. I can't find any related factors. Therefore, smoking, high blood pressure, high cholesterol blood Disease, unstable angina, age, gender and many other factors have at best low predictive ability. There is no. Conventional equipment / method Many approaches and devices for diagnosing and treating angiopathy have been proposed so far. It has been. U.S. Pat. No. 3,866,599 states cardiovascular to measure oxygen in the blood. Fiber optic catheters inserted into the system are disclosed. Oxidation level in blood To detect the light, first use an optical fiber to enter the blood from the tip of the catheter. Irradiate infrared light and red light. Infrared light and red light reflected by blood are light It is returned to the oximeter through the avior. Absorbed by reflected infrared light and blood The ratio to that is proportional to the oxygen saturation in the blood. In the design of this catheter , Preventing the end of the fiber from contacting the vessel wall at the end of the element There is also a recess for this. Also, by expanding the fiber, the vessel wall An outer sleeve is provided to further separate it from. However, the light of this patent The iva catheter cannot detect heat. In some conventional devices, temperature detection elements are used. U.S. Patent No. Nos. 4,752,141 include (1) optical fiber and (2) fiber along the optical fiber. Visible light or visible light provided at one end of the fiber to guide radiation to the other end A member containing a pulsed light source of electromagnetic radiation close to light, and (3) the end of the fiber or end It is located near the part and receives light, modulates it with temperature, and the modulated light The sensor that guides the light into the optical fiber and returns it to the sensor, and (4) the radiation source of this sensor. At least one is provided in the path of, and the characteristics of light change according to the magnitude of temperature change. (5) It is provided at the end of the fiber and receives the modulated light. Regarding the decay time of the emission intensity after the excitation pulse that shines and indicates the temperature of the sensor Temperature and / or using a system with components for measuring related functions Fiber optic sensing of other physical quantities is disclosed. These temperature sensors Is designed to make physical contact with the surface and is made of elastic material. It is formed at the end of the fiber, where a thin layer of phosphorescent material is deposited. ing. Phosphorescent materials respond to temperature and emit radiation. This radiation propagates through the fiber Then, it is detected by the sensor. To determine the contact temperature, measure the temperature It must be possible to install the catheter so that it comes into contact with the position. U.S. Pat. No. 4,986,671 states a single formed by an elastomeric lens. An optical fiber probe having a sensor of the above is disclosed. Reflects light on the lens It is coated with a temperature-dependent material that absorbs infrared radiation. A layer of material is coated to determine thermal or heat transfer properties. Sea urchin. One of the applications is to measure the pressure, flow rate and temperature of blood in blood vessels. Thetel. There are other methods using another device that detects heat. Sensitivity and / of these devices Or the toxicity is unknown. U.S. Pat. No. 4,140,393 states that the temperature probe A birefringent material is used as the material. U.S. Pat. No. 4,136,566 is a temperature sensor As a result, we are proposing to utilize the temperature-dependent light absorption characteristics of gallium arsenide. U.S. Pat. No. 4,179,927 describes gaseous materials with temperature-dependent light absorption properties. Are listed. Other approaches utilize the excitation method to detect heat. U.S. Patent No. 4, No. 075,493 uses luminescent material as the temperature sensor. One Exciting radiation in the wavelength range and propagating it from the measuring device along the optical fiber, depending on temperature Luminescent radiation is emitted from the sensor along the optical fiber for transmission. Is returned, and is detected and measured by the measuring device. Most measured using optical fiber Also Luminescent sensors are highly practical. It is stable and has a wide temperature range That is, the fluctuation of light due to the influence other than temperature is the smallest, and the size of the sensor is small. For some reason. Lumi that can be used to measure the flow velocity of a fluid, among other related parameters An example of a Nescent fiber optic probe is disclosed in U.S. Pat. No. 4,621,929. To. Guide infrared radiation along the optical fiber to the sensor and absorb it by the material layer .. Once heated, a fluid is run to cool the sensor. This cooling is Lumine Detected by a cent sensor. Cooling rate is the heat transfer characteristics and flow rate of the surrounding liquid Is proportional to. U.S. Pat. No. 4,995,398 states that during cardiac bypass surgery, before closing the chest cavity. I use thermography to check that the surgery was successful. This special Forgiveness describes the use of scanning thermal cameras, image processing, temperature differences and real-time image display. It is listed. The present invention uses a cold injectate. Cooling Note Ingredients, when mixed with warm blood, detect stenosis at distant anastomotic sites Images can be captured on a thermal camera that is focused on the heart. U.S. Pat. No. 5,046,501 states that atherosclerosis plaque and structurally raw Growing tissues are preferably obtained from lasers and can identify these tissues35. A method of identifying using a fluorescent beam with a single excitation wavelength between 0 nm and 390 nm It is disclosed. No catheter is used in the example of this patent. Therefore, this Insitu imaging is not disclosed and taught in the patent Absent. In addition, this patent predicts plaque rupture, restenosis or transplant vascular pathology. No method is described for this. U.S. Pat. No. 5,057,105 states heaters, caps, thermocouples, and power leads. With a wire and a lumen provided in the center of the terminal to place the catheter into the artery A high temperature tip catheter assembly is disclosed. Thermocouple is a catheter It is used to prevent overheating by continuously monitoring the heating of the. When properly placed on top of the formed plaque, the tip melts the plaque. U.S. Pat. No. 5,109,859 describes ultrasound-guided laser angioplasty. It is disclosed. This is because of the laser on the tip of the catheter and the guide To This is also an ultrasonic device installed at the tip of the laser, and a stable and blood-free environment. It has a proximal occlusion balloon to provide. Obviously, this patent is puller It is also related to assessing the mass of the tissue. This patented ultrasonic device Tissue structural features (ie, which cells and extracellular matrix are in the plaque) Nothing is taught as to whether it is identifiable. Therefore, this device breaks plaque Not likely to be used to predict cracks. In fact, recent studies have shown that ultrasound inside blood vessels Knows that it is not possible to identify which plaque is at risk of rupture .. De Feytia, Circulation 92: 1408-13 (1995). U.S. Pat. No. 5,217,456 states an intravascular guidewire compatible catheter. Is disclosed. This catheter has an irradiation light source and a synchronous fluorescence detector. ing. Light with a wavelength that induces fluorescence in the tissue is provided on the side of the catheter. It is radiated in the radial direction from the opening. Fluorescence emitted from the tissue passes through the same opening Then, it enters the catheter and is carried to the spectrum analyzer. With this information , Healthy tissue can be identified from atherosclerosis plaques. Deer However, this device does not perform plaque identification based on temperature difference. U.S. Pat. No. 5,275,594 states that it will analyze light emission from the target site. Therefore, methods and devices for distinguishing atherosclerosis plaque from normal tissue It is disclosed. This system is a non-calcified atherosclerosis plastic Laser light source and analyzer for exciting fluorescence from calcific and calcified material have. The analyzer targets the spectrum of fluorescence emitted by the tissue. Atherosclerosis with or without calcification at the site Calcium light emission after fluorescence excitation of calcium to see if it represents a lark Determined based on the time domain signal of morphism. Atherosclerosis plaque identified When it does, the plaque is excised using laser energy. There are many traditional approaches to intravascular arterial diagnosis and repair, but how many I'm not doing well in that ability. In particular, conventional catheters and methods are It does not provide a means for detecting and treating loam arteriosclerosis plaques. Na If so, they can determine the presence or absence of plaque calcification Even plaques that are at risk of rupture and obstruction and at the moment there is no such risk This is because it is not possible to distinguish it from plaque. Similarly, the conventional app Roach is at risk of arterial restenosis after angioplasty or atherectomy It does not provide an effective means for identifying a particular arterial site. Traditional appro The church also does not provide a practical and effective means for detecting transplanted vascular pathology. I. Traditional approaches have extensive scar tissue areas and lipid pudding without cell infiltration. At high temperatures, such as in areas of bleeding or blood clots where inflammatory cells will proliferate. It is also not possible to effectively identify patients with cold arterial wall regions. Outline of the invention The present invention is an infrared sensor for detecting inflammatory cells and parietal cells that generate heat. To provide a single catheter to predict the behavior of injured blood vessels in medical patients Therefore, it overcomes at least some of the problems of conventional technology. To this invention Cathetering and methods are at risk of rupture and obstruction, among other diseases. It is possible to distinguish between plaques that are not dangerous at this time. Provides an effective means for detecting and treating telom arteriosclerosis plaques To. Catheter and method according to the invention are also after angioplasty or atherectomy. Identify specific arterial sites that are at risk of arterial restenosis, or which patients Provides an effective means of identifying at risk due to vascular pathology or tissue rejection ing. Hazardous areas due to inflammation can be identified by their high temperature or below normal Temperature (the area colder than the rest of the blood vessels) is actively metabolizing health It indicates that there are no cells (the heat of the human body is a cell that is actively metabolizing. The catheters and methods according to the invention also include it (because it arises from). Has an abnormally cold arterial wall, which is a dangerous arterial region that was not detected until Patients can be effectively identified. Non-cellular areas are generally bleeding, blood clots, choleste Pools of rolls or areas of calcium, all of which are at high risk It is an indicator of plaque. The apparatus and method of the present invention sense the temperature difference in the blood vessel wall. These objectives have been achieved by separate analysis. In some respects, the invention relates to a device for analyzing light emission in blood vessels. To do. In another respect, the invention relates to a method of analyzing light emission. This way Is most preferably carried out using the apparatus of the present invention. The light emission of particular interest in the present invention is an optical spectrum in the wavelength range of about 2-14 μm. It is a radiation that has a torr. The attractive feature of infrared is (compared to white light and ultraviolet light). ) Permeate calcium. Outside Benaron, (J Clin Monit) 11 : 109-117 (1995). The tubes of particular interest in the present invention appear to be difficult to access to their surface. Blood vessel. Therefore, the inner diameter of the tube is too small to be a conventional temperature probe (ie, If it is not easily accessible with a contact thermometer or thermocouple), this output Usefulness will be found in Ming's devices and methods. Similarly, a sufficiently large inner diameter Have access to the temperature probe, but the opening of the tube is narrowed or If the device is blocked or blocked, the device of the present invention and Usefulness will be found in the method. Therefore, the application of the apparatus and method of the present invention. Of particular interest in, such as arteries, veins, blood vessels, ventricles, chambers, etc. A blood vessel in the human body that contains a tube that circulates and transports serum (ie, blood). The present invention is an apparatus and method in which at least one optical fiber is used. Regarding. Optical fibers are usually from the end of the fiber, which is usually located inside the blood vessel. Light radiation can be transmitted to the proximal end of the fiber located outside the blood vessel. this Some of the optical fibers of the invention are capable of transmitting wavelengths in the range of 2-14 μm. It has the key parameters of. Some of these key parameters are optical transmission Includes sex, flexibility, strength, etc. The optical fiber of the present invention has a very small diameter. Extruded to transmit over the appropriate infrared spectral region It is a fiber. Infrared optical fiber is zirconium fluoride (ZrF)₄), Various types known to engineers in the field, such as quartz and chalcogenide (AsSeTe). It can be composed of materials. ZrF₄Fibers are used in the devices and methods of the present invention. Very suitable. Because these fibers are small in diameter, 1 meter This is because it has a transmittance of 90% or more per hit. In addition, an attempt was made to investigate an optical fiber that can be used in the apparatus and method of the present invention. It is like being able to be installed near that part of the duct wall. This standard is light This can be partially achieved by the flexibility of the fiber. Other parts of this standard Minutes are filled by the very small diameter of the optical fiber. The apparatus and method of the present invention also utilize a balloon that wraps around the end of the optical fiber. There is. In one preferred embodiment, the balloon is targeted for light emission. On the other hand, it is transparent. In that case, the light from the outside of the balloon will be on the balloon. It penetrates the outer surface and reaches the inner surface of the balloon and the light emission point of the optical fiber. To reach. In this preferred embodiment, the light source (ie, tube wall, plaque location) Absorption and reflection of light radiation when it passes through the balloon Or it is very important that other spreads, if any, are very small. This Such unwanted absorption is caused by blood or other body fluids. Therefore, Transparency for the purposes of the present invention radiates almost any light emitted from a particular light source. It means the ability to transmit to optical fiber through the surface of the rune. In this preferred embodiment, almost all heat is conducted, while the balloon Light source (ie, vessel wall, plaque location, etc.) when contacting the outer surface of It is important that there is almost no loss of heat emanating from. Therefore, an object of the present invention Opacity (nonconductivity) is the emission of light from a specific source on the outer surface of the balloon. It means to absorb almost all of. After that, the inner surface of the balloon is light Amount proportional to the amount of radiation absorbed on the outer surface immediately adjacent to the location of the emission Re-emit the radiation. This re-emitted radiation is the light located inside the balloon. Detected by fiber. The device and method of the present invention emits average light along the wall of the vessel under investigation. A detector that can detect the difference in the light emission of interest between Is also used. In certain preferred embodiments, the detectors of the present invention emit infrared radiation. It seems that it has a sensitivity that can detect the difference in the range of 10 to 100 ° mK up to 50 ° mK. It is a thing. The balloon was released directly from the vessel wall outside that or at a particular location. If transparent to radiation, the detector is via the outer and inner surfaces of the balloon. It is like being able to detect the transmitted radiation. The balloon is at that location or When it is opaque to the radiation emitted directly from the blood vessel part outside the specific part The detector is in direct contact with the location of the balloon opposite the outer surface of the balloon. It is like being able to detect the radiation re-emitted from the inner surface of the cage. In a preferred embodiment, the apparatus and method of the invention is in the range of infrared radiation. It depends on the detection of light radiation. In particular, as described above, the apparatus and method of the present invention. In particular, the range of 2 to 14 micrometers is targeted. See Figure 2 As you can see, various constant temperatures (300 to 310 ° K, which differ by 1 ° K from each other) Emitted from a blackbody maintained at T1, T2, T3), which represents the temperature of the enclosure, respectively. Plot the curve for the emitted radiation in the wavelength range of 3 to 6 micrometers. Can be done. As can be seen from the inset in Figure 2, the range is approximately 5.3 to 5.6 micrometers. At a constant temperature in the range of 300 to 310 ° K, which differs by 1 ° from each other. The held blackbody represents an easily identifiable curved part, and from these blackbody Approximately 0.21 x 10¹⁷From 0.40 × 10¹⁷Photons in the range of photons are emitted. Obey And specific on the vessel wall and on the vessel wall so that similarly identifiable curves are obtained. It is preferable to select a wavelength for sampling the radiation from the location. In certain preferred embodiments, the devices and methods of the invention are at least two. You are using fiber. When detecting at multiple points along the axis of a blood vessel at the same time It is obviously possible to use more than one fiber if there is an advantage, such as is there. In other preferred embodiments where at least two fibers are utilized At least one of the fibers is a reference fiber and another fiber is the signal Fiber for use. The signal fiber emits all the light focused on the fiber. A fiber designed to transmit from end to base. On the contrary, the reference fa Iba is a fiber used as a control to which the transmission of signal fibers is compared. .. Therefore, is the light emission emitted from the base end of the signal fiber the base end of the reference fiber? When compared with the light emission emitted from, the radiation emitted from the target location Easily determine the relative amount of light emission emitted from the signal fiber due to external radiation Can be squeezed. The device of the present invention emits light in the radial direction at the end of the signal fiber. Is optically connected to the end and the optical reflective surface leading into the fiber. Some of the inventors of the present invention are co-inventors, the United States referred to herein. Patent Application No. 08 / 434,477 describes such an optical reflective surface. Signal fa Unlike Iba, reference fibers generally emit most of the light to the reference fiber. The end is coated with a material that prevents it. The device of the present invention also has an opaque closure balloon with an inner surface that allows the balloon to pass through. It emits a blackbody spectrum modulated by a spectrum. Balloon When inflated, it almost limits the flow of fluid in the blood vessel. Required flow rate limit Increases mean background IR radiation along the vessel wall immediately adjacent to the end of the inflated balloon It is like a flow that does not increase or decrease. In addition to that, good In a further embodiment, the device of the present invention is a balloon when the balloon is inflated. Presence of fluid in the vessel between the internal fiber and the vessel wall closest to the test site Is almost eliminated. In use, the device of the invention is installed along the axis of the blood vessel. In this way Bring the diagnostic fiber array very close to where you are going to diagnose Is possible. In some preferred embodiments, the site contains plaque. This is the place to go. In particular, devices such as those mentioned above are pullers that the device is brought close to. Detects whether the plaque is at risk of bursting It is useful when you do. In most cases, the device of the invention is located on the inner wall of a blood vessel. It is used to diagnose the temperature difference. The device of the present invention is, in its most preferred embodiment, a catheter. As is customary for catheters used inside blood vessels, the catheters of the present invention are guys. Designed to be used with Dwire. For example, the category of this invention After diagnosing a plaque at risk of rupture using a tel, the surgeon is in trouble Have another diagnostic device or treatment device such as a laser in the same location adjacent to one plaque When you want to come, take it out at the surgeon's discretion with the guide wire or again Can be inserted. In the apparatus of the present invention, preferably, the detector is optically connected to the base end of the fiber. Also, when there are multiple fibers, light is applied to the base end of each of those fibers. It is scientifically connected. In a preferred embodiment, the detector has multiple wavelengths. Radiometer. Such a radiometer is preferably a rotary circular variable filter. This fi The transmission wavelength of the rut is a function of its rotation angle. In these filters By adjusting the rotation angle, only a very narrow wavelength band can be transmitted. It is possible to do. In other words, these filters depend on their rotational characteristics. Can be made to be transparent only to highly selected wavelengths .. Therefore, in one preferred embodiment, this filter is approximately 2-6 micron. It is transparent to radiation with a wavelength of meters. Very preferred embodiment odor The filter is transparent to radiation with a wavelength of approximately 3 micrometers. Is like having. One of the keys to this invention with respect to the device is sampling about 3 micrometers. By doing so, a reference for each spectrum is automatically provided. Living At this wavelength for the expected temperature range of 300-310 ° K in organs The blackbody spectrum is essentially the same. This allows for each signal B is given and the low wavelength side of the signal is locked. If you don't do this, it's vertical There is no way to match the signal to the blackbody spectrum because the orientation is "unfixed". Transmission information from multiple fibers through a filter for comparison by the apparatus of the present invention When using information, it is preferable that the end of the fiber is provided with a deviation. .. Therefore, when the ends of the signal fiber and the reference fiber are offset from each other. This shift is emitted from each fiber and passes through approximately the same location on the filter. The radiation is provided at a sufficient distance to sample. The device of the present invention produces transmitted radiation when used with a radiometer. Optically connected to at least one photoelectric device that can be converted into an electrical signal Is preferable. This photoelectric device is a device that digitizes electrical signals (digital tie). It is preferable that it is electrically connected to the). Once a digital signal is generated by the device of the present invention, it is approximately 300-310. This is a curve selected from the spectral curves for blackbody maintained at temperatures between ° K. Mathematically fit the digital signal of. The controlled blackbody curve is each black It is plotted for each wavelength as the number of photons emitted by the body. Digi Typical of the human body when diagnosing temperature differences on the inner walls of blood vessels using Tal signals Select a specific blackbody control curve based on knowledge of different temperatures. Therefore, in a preferred embodiment, the apparatus of the present invention analyzes the infrared radiation of blood vessels. It is a catheter to do. This device is capable of transmitting radiation and blood Can be installed along the axis of the blood vessel near the plaque-containing part of the inner wall of the tube It has at least two capable fibers. At least one of the fibers Is a reference fiber, and most of the light radiation is incident on the fiber at the end. The material is coated to prevent it. With at least of the other fibers One is a signal fiber, the end of which is a shaft that emits light generated in the radial direction. Optically connected to an optical reflective surface that can guide the inside to its end along it To. The device also has a balloon that wraps around the end of each fiber. This baroo When it expands, it almost restricts the flow of fluid in the blood vessels. Also, this balloon Almost eliminates fluid between the fiber and the vessel wall closest to the area to be examined To. Balloons are transparent or opaque to radiation generated inside blood vessels and are spatial Has an inner surface with a constant emission rate of light emission. Inside an opaque balloon The side surface is capable of emitting a blackbody spectrum. Catheter with guide wire Have. The catheter also has a detector optically connected to the base of each fiber ing. This detector is of radiation between that location and the average light emission along the vessel wall. The difference can be detected. The detector is also multi-wave with a rotary circular variable filter It also has a long radiometer. The filter's transmission wavelength is a function of its rotation angle It's like that. The ends of the fibers are emitted from each fiber and of the filter Mutual enough distance to sample radiation passing through approximately the same location above I'm being staggered. In addition, the radiometer electrifies the transmitted and filtered radiation. Optically connected to at least one photoelectric device that can be converted into a signal ing. The electrical signal is digitized, and this digital signal is about 300-310 ° K. Number for the curve selected from the spectral curves for the blackbody maintained at a temperature between It is made to fit scientifically. The curve shows the number of photons emitted from each blackbody And plotted for each wavelength. The present invention is also used in diagnosing medical conditions in certain preferred embodiments. Regarding suitable analysis methods. Therefore, the present invention analyzes the light emission at a part of the blood vessel wall. Regarding how to do it. Because the method of the present invention transmits radiation near this point It has the stage of installing at least one optical fiber that can be installed. Preferred Examples In, the installation of fibers and balloons is performed using the catheter insertion method. .. Wrap the ends of the fiber before or after installation near the site to be analyzed The balloon is inflated inside the blood vessel, and the balloon causes the flow of fluid inside the blood vessel to flow. Restrict. As detailed above, balloons are transparent or opaque to heat radiation It has an inner surface with a spatially constant light emissivity. The method of this invention It also requires a step of transmitting radiation to the detector along the fiber. This detector Can detect the difference in radiation between that location and the average light radiation along the vessel wall it can. More specifically, the invention risks rupturing with plaque along blood vessels. Regarding how to detect something with. This method tries to diagnose the guide wire The stage of insertion into a blood vessel and then transmission of infrared radiation along the axis of the blood vessel. A catheter with at least two fibers capable of And insert it into the blood vessel and insert it near the part of the inner wall of the blood vessel that contains plaque. It has a stage to enter. Then the steps of the method of the invention are described above. Do it this way. The invention also surgically treats patients with numerous plaques inside blood vessels. Regarding the method. In this method, which of the multiple plaques is the average blood vessel It has a step to determine if it has a temperature higher than the wall temperature. Once this When making the decision, the surgeon removes the plaque area found to have a high temperature Or reduce. This method, as a deciding step, is a plaque site on the vessel wall. It has the method described above for analyzing the light emission of. Dangerous plaque Once identified, many treatments can be used to reduce the risk .. Therefore, an object of the present invention is to identify a particular plaque at risk. Has atherosclerotic plaques of the coronary arteries at risk of rupture To identify the patient. Another object of the present invention is a particular arterial lesion at risk. By identifying the location of arterial restenosis after angioplasty or atherectomy Identifying patients at risk. Another object of the present invention is the transplantation of vascular pathology. Identifying patients at risk. Another object of the present invention is the carotid artery, cerebral artery. Where plaque can rupture in the aorta, iliac and femoral arteries Risk for stroke, motor dysfunction and other illnesses by identifying Identifying sexually ill patients. Another object of the present invention is extensive scar tissue. Area, lipid pool without cell infiltration, or bleeding or blood clots from which inflammatory cells proliferate Identifying patients with cold rather than hot arterial wall areas, such as areas of And. Determining the contour of the cholesterol pool is for tracking plaque degeneration It is useful. Identification of such areas for follow-up studies will cause future inflammation Areas that are easy to identify are identified. Yet another object of the present invention is specific to the area of injury identified by the catheter. Local treatment is given. Inflammation (recrete of inflammatory cells) Mention, attachment, activation, proliferation), smooth muscle cell proliferation, or antibody, conversion Growth factor-β (TGF-β), nitric oxide (NO), NO synthase, glucocol Tycoid, interferon gamma, heparant and heparin sulfate proteogly Infection of endothelial cells, including cans and the various complementary DNAs that encode them It includes, but is not limited to, preventive or limiting treatments. The methods and devices of the present invention have many uses. They are coronary or carotid arteries Atherosclerosis will reduce disease and mortality. Also, they Needs to reduce restenosis and therefore repeat angioplasty and atherectomy Will be reduced. They also suppress the development of vascular pathology in organ transplant patients Will be. By extension, these achievements will lead to better health care and public health. Will improve and reduce the cost of health care. Such advantages of this invention Usability and other uses will be further clarified by the detailed description below. A brief description of the drawing FIG. 1 is a schematic view of the apparatus of the present invention. This device has an infrared detector at its base It also has a sensor attached to the tip of the end of the catheter, optical phi Inside a flexible outer catheter (not shown) that encloses the bath A guide wire is arranged in the. Figure 2 shows for temperatures T1, T2, and T3 (which differ by 1 ° Kelvin in sequence). It is a blackbody spectrum curve, and the radiation and wavelength (My) expressed by the number of photons (× 1E17). It is a plot of the relationship (chrome meters). Figure 3 shows the catheter in Figure 1 placed in a blood vessel near a plaque at risk of rupture. It is an axial sectional view of the tip of a tel. Figure 4 (a) depicts the relationship between the surface temperature and cell density of live carotid plaques. It's rough. Relative cell density is the cell density of the area of interest and that of the background area It is a ratio with. Temperature measurements were taken from 22 patients 10 to 15 minutes after removal. The sample was subjected to room temperature (20 ° C). Points (temperature difference 0 ° C) represent 27 observations To. Figure 4 (b) shows a living human carotid plaque measured in a chamber at 37 ° C. It shows the correlation between the temperature of the cells and the cell density. Figure 5 is a graph depicting the plaque surface temperature as a function of cap thickness. Area measurements were performed on samples with non-inflamed fiber caps , The distance from the lumen to the center of the underlying cell cluster was measured. Figure 6 shows a live human carotid plaque sample (fresh in a 37 ° C chamber). Shows the correlation between thermistor and IR camera measurements in (incised) To. Here, r = 0.9885 and p = 0.0001. Figure 7 shows the correlation between IR radiation and the cell density in the sample mentioned in Figure 6 above. ing. Description of preferred examples <Catheter Examples> Refer to the drawing here. FIG. 1 shows preferred implementation of the apparatus of the present invention in use. An example is shown. In the figure, so that it can be installed inside an artery (not shown) The catheter device 10 is shown. Arteries have numerous plaque locations (figure) Has an inner wall (not shown) with (not shown). One of them The risk of larking bursting is until the methods and devices according to the invention are applied. do not know. The guide wire 20 is surgically inserted into the artery and has a proximal end 22 and a distal end 24. It can be seen that it extends to both. The guide wire 20 is also a catheter device 10 You can also see that it extends inside. The guide wire 20 is a plastic catheter device 10. It is used to install in the arterial area that contains the area. The catheter device 10 is inflated at its end (the end farther from the detector). It has a possible balloon 40, a signal fiber 50, and a reference fiber 60. There is. The inflatable balloon 40 is depicted in its inflated state. Balloon By swelling, it is firmly abutted against the inner wall of the artery and the plaque site. Position 3 by inflating the balloon 40, depending on the direction of the original blood flow in the artery 2 or a generally circular piece between position 34 or the wall 42 of the balloon and the inner wall of the artery Blood flow is largely restricted at similar points around the point of contact of the ream. to this Therefore, it becomes possible to perform measurement with the catheter device 10 without receiving interference. To. The balloon 40 has a wall 42 formed of an elastic material. Balloon 40 In the surrounding area, the balloon is sealed or occluded along the arterial wall due to expansion. It is something like that. When contracted, balloon 40 does not contact the arterial wall Then, the original blood flow in the artery is resumed. In addition, the catheter device 10 For example, catheter device 10 is used to measure the radiation emitted from another plaque site. It is possible to easily move to the next position in the artery, such as the position to be .. Performing expansion / contraction of balloon 40 is an angioplasty or occlusion catheter, or Is a number of methods well known to technicians in the field of manufacturing catheters with balloons at the tip. Can be done by. The purpose of the balloon 40 is the source of the infrared radiation to be measured and the catheter part at the end. This is to avoid problems related to the absorption of infrared radiation by water between minutes. When inflated and in contact with the vessel wall, the balloon wall 42 moves with the wall 42 closest to it. It becomes the temperature of the pulse part. The gap 46 is between the inner wall of the balloon and the end 56 of the signal fiber. Eliminate all water in between. The signal fiber 50 has a transparent tip portion 52 and an opaque body portion 54. There is. Each of these parts can efficiently transmit infrared radiation. Or not. The opaque body part 54 is the signal fiber 50 Is the area covered by the clad or sleeve 56. Sleeve 56 Make the area opaque so that infrared radiation cannot be efficiently transmitted or absorbed I have to. The transparent tip 52 is simply the area where the signal fiber 50 is exposed. is there. The signal fiber 50 is an optical fiber capable of efficiently transmitting infrared radiation. It's ba. In order to collect such infrared radiation from the surroundings, the signal fiber 50 The light collecting device 58 is attached, or the light collecting device 58 is attached to the end of the light collecting device 58. It is used. The condensing device 58 focuses the ambient infrared radiation into the fiber. And then transmit. Unlike the signal fiber 50, the reference fiber 60 has no transparency. .. Instead, the reference fiber 60 has an opaque end 62 and an opaque portion 64. And have. Neither of these can efficiently transmit infrared radiation .. As in the signal fiber 50, the opaque portion of the reference fiber 60 6 4 is the area where the reference fiber 60 is covered with a clad or sleeve 66. is there. The sleeve 66 makes the area opaque and efficiently transmits and absorbs infrared radiation. I try not to put it in. Opaque end 62 is ground to reference fiber 60 Infrared reflective coating such as polished silver or aluminum is coated This is the area that is being used. In all other respects, the reference fiber 60 emits infrared radiation. The odor of functioning as an optical fiber that can efficiently transmit light It is the same as the signal fiber 50. Therefore, the reference fiber is a signal fiber. Baseline to compensate for any temperature characteristic from end to base along 50 Can be used as. Reference fiber 60, as shown in Figure 1. Is offset from the signal fiber 50 towards the proximal end. This shift (toward the end) It is also possible to squeeze) the radiation received and transmitted by each fiber. Physically cause a time dilation between. This time delay, as discussed immediately below The signal beam emitted from the base end of each fiber and the reference beam are in the same space of the filter. It is introduced to make it incident on the part. By doing this, Ara Bandpass non-uniformity caused by imment problems and multi-filter systems You can get rid of sex. During operation, the fiber and balloon array 70 collects heat radiation and emits this radiation. It is transmitted toward the base end via the signal fiber 50 and the reference fiber 60. Both The fiber passes through the rotary radiometer 80 at the same radius position 82 and is a digital device. It is arranged so as to be incident on Isa 92 and 90. From the transmission of each optical fiber When a digital signal is generated, the digital is transmitted by the signal fiber 50. The background signal generated by the reference fiber 60 from the tall signal is the computer 9 It is deducted by 4. The resulting adjusted signal is a blackbody spectrum Fitted by curve 96 and computer 94, temperature at a specific location To confirm. <Catheter structure> As a material for various other members of the catheter device described here, yes There are several options. The key parameters of optical components are optical transparency and acceptance. Vulnerability and strength. High-strength polyester and polyethylene terephthalate ( PET) is very transparent and can be easily extruded into very thin walls. Ah Move the twist over a long distance, as required in one of the embodiments (t). High-strength knitted polyester is useful for ranslate). Spacer / Beyarin Can be formed from Teflon. The flexibility of the entire catheter is similar For fiber optic angioplasty and atherectomy using dimensional cardiovascular lasers It will be about the same as a catheter. Therefore, these devices are small diameter coronary arteries. Must be able to bring it to. Base end of catheter (outside the patient) InSb or HgCdTe, TeO₂Or a detection system consisting of TAS A detector using the system is installed. Elongated flexible optical fiber ends at an optical connector via a protective sheath It is connected. The optical connector is now slid into the heat detector It is a standard one. The optical connector has a large number of openings on one side A gas such as fluid or air is introduced into the catheter through this opening. It is also released from there. The connector is also a pressure transformer for measuring pressure It also has a coupling element for connecting to the user. No. elements and cutters on the connector There is an opening that communicates with Tel's pressure lumen. The binding element is also a blood cell Also connected to a syringe to collect samples and flush saline through the catheter .. The material that forms the catheter is nylon, Teflon (trade name), etc. Plastics, vinyl such as polyvinyl chloride, polyurethane, polyethylene, Alternatively, any commonly used one including various rubber compounds may be used. General In addition, the catheter is 12.7 to 101.6 cm (5 to 40 inches) long and is about 1 to 2 millimeters long. It has the outer diameter of the tor. Lumens inside the catheter vary, but are generally straight The diameter is 1/2 to 1 mm. The minimum temperature difference that can be detected using the device and material of the present invention is about 0.1 ° C. This The device of the invention is capable of finer temperature discrimination, but due to biological fluctuations. The system is prone to noise. Plaques at risk of rupture in most cases Fluctuates by at least 1.5 ° C than the less dangerous ones. <Dangerous plaque> Then, in general, as an overview of the apparatus and method of the present invention in FIG. Catheter 100 is ulcered atherosclerosis plaque 1 02 is identified. Plaque 102 is an aggregate of platelets 103 and vasoconstriction 10 Accompanied by 4. Because inflammatory cells 105 are present in this plaque 102, Its temperature is higher than that of the immediately adjacent blood vessel 107. This difference is Katete Detected by Le 100. Some endothelial cells 108 are lost (aging) , As a result of inflammation, infarction, toxins or balloon wounds), thereby platelets 109 is activated and attaches to the damaged vessel wall 110. Activated blood small Plate 109 releases mediators that cause vasoconstriction, platelet assembly and smooth muscle cell growth Put out. These mediators include ADP, serotonin, thromboxane A₂,platelet Includes induced growth factors, converted growth factors-β and PF4. Collagen in the endothelium Enzyme activity of coagulation enzymes by exposure of 111 and lipid 112 and activation of platelets Sex is promoted. As a result, the release of hemolytic mitotic agents and fibrinogen Activation of thrombin, an enzyme that tears and forms fibrin, occurs. This of The most advanced process results in complete occlusion of the arteries, resulting in the heart (carotid artery, spinal cord). In the case of arteries or cerebral arteries, the brain) is damaged. The figure also depicts the monocyte 114. Monocytes 114 are of activated endothelial cells Adhering to adherent molecules on the surface. Monocytes take up modified cholesterol, secondary Mitotic agents that promote rupture as products, and proteolysis that promotes rupture It becomes a macrophage in connection with the release of the enzyme. Example I: <Method> Live 50 carotid intima removal surgical samples after macroscopic examination by a pathologist I looked it up in. Visible thrombi found in about 30% of the sample are generally a gradual wash Was removed by. This means that they are surgically artificial It suggests. The guideline for surgery is generally carotid artery stenosis or transient ischemic attack. Rui has a stroke. Twenty-four samples from 22 patients were examined at room temperature (20 ° C). Another 26 from 26 patients Samples were examined in a wet incubator at 37 ° C. Cole with a 24-gauge needle tip within 15 minutes after removing the sample -Cole-Parmer model 8402-20 Thermistor (accuracy 0.1 ° C, time constant) Using 0.15), the temperature of the tile lumen surface was measured at 20 points. temperature Are reproducible (± 0.1 ° C) and most measurements are found to be within 0.2 ° C of each other. won. Therefore, this was used as the background temperature. In most plaques, some places with high temperatures are all found It was. Mark these areas and the background temperature with various colors of indelible ink ( Recorded, but not coded to indicate temperature to pathologists), ensuring reproducibility Remeasurements were made to chew. Then fix the tissue in 10% formalin and length A process for examining the tissue structure by cutting in the hand direction and embedding the intima and medium so that they can be seen. Do the rationale and dye with hematoxylin and eosin or Masson trichrome Color or use the aforementioned HAM-56 and KP-1 antibody (Dako) Immunostaining for macrophages was performed. Outside Nikkari, Circulation 92: 13 93-1398 (1995). Of the cap in the 300 x 400 μm area below the stained area Thickness and cell density, Macintosh Centris 650 and National Ins, Bethesda, Maryland, Leland NIH image processing software available on the Internet from titute of Health Measured using John 1.43). Jet Propulsion Laboratory's Kay Platinum Camera? Preliminary experiments were also conducted using this. We use this as a Mach 5 scanning infrared camera (d) Flexitherm, Westbury, NY Calibrated with. Then school this with water in beakers of various temperatures in the range 0-100 ° C. When corrected, a nearly perfect correlation y = 0.99x + 0.31 was obtained. Here, x is the temperature measured with a mercury thermometer. This camera has a temperature resolution of 0.10 ° C and 0. It has a spatial resolution of 15 mm. <Result> The plaque has good surface temperature reproducibility and can withstand changes of 0.2 to 0.3 ° C (± 1.0 ° C). Had many areas. And 37% of plaque is 1-5 per plaque It had a warm (0.4-2.2 ° C) region. For example, in the typical case, 1 mm apart The reproducibility of the affected area was good, and the temperature difference was 0.6 ° C. Plaque lumen table The surface had visible dysplasia, but the temperature difference was not apparent to the naked eye. This Their temperature difference was positively correlated with the lower cell density (r = 0.68, p = 0.0001) ( See Figure 4A). Most of these cells have macrophage morphological features and ( It was a mononuclear cell with immunoreactivity (with HAM-56 and KP-1). Some mitotic features were seen. Also, some foam cells were seen However, the area dominated by foam cells was cooler than the infiltrated area of mononuclear cells. (And the cell density was also low). Many plaques have a small number of lymphocytes and mast cells Included. The temperature changed in inverse proportion to the thickness of the cap (r = -0.38, p = 0.0006) (Fig. 5). checking). The maximum correlation (r = 0.74, p = 0.0009) is the theoretical prediction formula ΔT = Given by relative cell density ÷ cap thickness. Non-cellular tissue in cold regions Choleste without fresh blood clots, bleeding, scar tissue, calcium or inflammatory infiltration It was an area of the roll pool. The hot regions had a surface layer, many of which consisted of inflammatory cells, but meat An eye examination did not show any difference. Some of them have an aggregate of platelets Was there. There were no inflammatory cells in the other large area, but no endothelial cells. These are It was probably stripped off during the surgery. Because in autopsy, blood clots and inflammation This is because unless there is, only local exfoliation is usually seen. Outside the fandom, Cardiobascula Pasolozi 3: 9-17 (1994). A small number (about 20%) of plaques could not detect thermal dysplasia. These trials Deep or superficial inflamed areas in the material were not marked with dye. this is, It indicates that the high temperature was not measured. In areas containing cell infiltrates Temperature was measured in some areas. They are more temperature than adjacent less cellular areas Was never expensive. Inventor for a long time after this discovery was taken out May reflect a decrease in metabolic activity in samples maintained at room temperature I thought. Therefore, another series of plaques was analyzed in an incubator at 37 ° C. Average year Cells from these 26 samples from 26 patients aged 68 years (range 50-86 years) Closer correlation with density (R = 0.68, p <0.0001) and more (93% of sample) ) Temperature dysplasia and a large temperature range, generally 1-3 ° C, were revealed. Only 10mm Some samples that were not separated were characterized by a temperature difference of 4-5 ° C. Figure 4B See (dots represented by black diamonds indicate relative cell density cap thickness It is divided by the square of. The results of linear regression analysis of these points are shown in solid lines in the figure. Has been). The present invention also has a temperature resolution of 0.1 ° C and a spatial resolution of 0.1 mm. Several samples were examined using a cooled infrared camera from. This camera is a half-vibo sample Detected thermal dysplasia. As shown in Figure 6, the IR camera is temperature When used to identify different plaques, the IR camera excised fresh Good correlation with thermistor measurements in direct contact with human carotid plaque samples (R = 0.9885, p <0.0001). Figure 7 shows this correlation of temperature measured by an IR camera. It is shown that it is also found for cell density measurement. According to the present inventor, cooling type Steering array camera has better temperature resolution, spatial resolution is 10μ m. <Conclusion> Most human carotid artery atherectomy samples are mostly macrophages underneath It contains hot lesions that are clearly caused by the cells on the side. Examined at 37 ° C Occasionally, the temperature change was greater than 20 ° C. This makes the plaque temperature more uniform Consistent with reduced metabolic activity at 20 ° C. In samples examined at body temperature, a thermistor with a 1 mm tip Detects as much as 4 ° C difference in different parts of the same plaque that are only 10 mm apart I was able to When the cell is closest to the probe (ie, the lumen itself) The temperature was highest (at the body or just below it). Plaque lume Most of the surface has some areas characterized by surface inflammation and exfoliation of the endothelium. Had had. Only some areas of surface inflammation were associated with visible thrombi. Big The part is a small thrombus (for example, a small number of fibrin strands or attached platelets) Was associated with, but in some cases it was not at all. These results are plaque High temperatures are exfoliated and inflamed, so there is a risk of blood clots It suggests that it is an index of ku. The inventor also has a small number of inflammatory lesions just below a thin but healthy cap. I found a hot region. These plaques are considered to be at high risk of rupture Therefore, we have done this by measuring the temperature of the plaque in vivo. We believe it is possible to identify plaques. Example II: <Research Limits> The potential confounder identified by the inventor is Angio Genesis (angiogenesis). The inventor examined live plaques in half-vivo. In vivo, the presence or condition (tone) of vasae vasorum (vasa vasorum) ) May affect the temperature. But plaque angiogenesis is a flame Correlated with illness (Nikkari, Circulation 92: 1393-1398 (1995)), Temperature is in vivo because both are considered risk factors for plaque rupture. It seems that it can be used for prediction. The inventor is also true for atherosclerotic plaques in the carotid artery What may not be true elsewhere, for example in the coronary arteries I think we have to consider. Plaque pathology in two places Somewhat different (outside fandom, cardio bascula pasoroji 3) : 9-17 (1994)), risk factors are also different. Kannel, Journal Ka -Geovacula risk (J Cardiovasc) Risk) 1: 333-339 (1994); Charrette ( Sharrett) Outside, (Arterioscler Thromb) 14: 1098-1104 (1994). Example III: <Possibility of spectroscopy, tomography and interferometer> Infrared spectroscopy may be useful in several respects. First, the location of macrophages It should be possible to confirm by the mass of nitric oxide they produce. This is because nitric oxide has a unique near-infrared spectrum. order Outside Ohdan, Transplantation 57: 1674-1677 (1994). Of cholesterol Near infrared imaging has already been performed. Outside Cassis, Analytical Chemistry (Anal Chem) 65: 1247-1256 (1993). Second, the infrared and near-infrared wavelengths The longer the wavelength, the deeper the tissue penetrates, so the longer the wavelength You should be able to see the activity of metabolism in the deep part (0.1 to 1 mm). This phenomenon could be used to develop infrared computer tomography. Absent. At this time, in some cases, an interferometer is used together. Movable incident beam Bis that are divided by a mirror and scattered and absorbed in various ways by the reference beam and tissue. Divide into Reconstructing asynchronous reflected wavelengths in detail with a resolution of 20 μm Clarify the structure. Outside Benalon, Science 259: 1463-1466 (1993); Bregins Outside Ki (Brezinski), Circulation 92: 1-149 (1995). Example IV: <Non-invasive detection of dangerous plaque> Non-invasive infrared tomography due to differences in infrared absorption, convection, and tissue emission rate An alternative to infrared detection is desirable as it can be difficult. Among those Gallium (outside Pasterkamp, Circulation 91: 1444) -1449 (1995)),¹⁸FDG positron scanning, radioisotope-substituted antima Macrophage antibody fragments, or magnetic resonance (relaxation of photon spins makes temperature dependent Includes imaging of inflammation using the advantage of having). Macfall (M outside ac Fall, International Journal Hyperthermia (Int J Hyper) thermia) 11: 73-86 (1995). These methods work under the surface of moving coronary arteries (especially curved and terminal vessels). Lacking sufficient spatial resolution to detect inflammatory lesions in plaque It cannot be used to carry out current treatment "online". But the aorta, carotid, large Degradation in these methods for arteries with thick and relatively fixed walls, such as the femoral artery Noh may be enough. Outside Toussaint, (Arterioscler Thromb Vas Bi ol) 15: 1533-1542 (1995); Outside Skinner, Nature Medicine Medlcine) 1:69 (1995). If the inflammation of the lumen can be distinguished from the inflammation of the adventitia, the latter May be useful in predicting the progression of aortic aneurysms. Example V: <Therapeutic implications> Mortality by lowering serum cholesterol levels with diets and drugs Can be lowered. This is probably due to the reverse transport of cholesterol lipids This is probably because the core dimensions are smaller. But the most compelling test to date However, cholesterol-lowering treatment reduces coronary artery mortality by only 35% (so) And women have little benefit). Scandinavian Singh Scandinavian Simvastatin Su rvival Study Group), Lancet 344: 1383-1389 (1994). This discovery Hemostasis It suggests that other factors, such as variability in, influence mortality. But the same In the same patient, plaque progression or regression is relatively variable. Ghoul Gould, Circulation 90: 1558-1571 (1994). This fluctuation is a lesion-specific change Volume (eg, stenosis length, surface thrombus, low shear stress due to slow or turbulent flow, and blood It suggests that the risk of blood clots increases due to tube contraction, etc.). Alderman (Alderman) Outside, (J Am Coll Cardiol) 22: 1141-1154 (1993); Nobuyoshi ) Outside, (J Am Coll Cardiol) 18: 904-910 (1991). Risk of rupture of hot plaques causing stenosis in the "non-serious" range of 10% to 70% Should they be angioplasted if they are shown to be high? .. Stenosis with a higher risk of dilatation (about 1% mortality and 2% aortic-coronary artery) If it is similar to Ipas), the probability of long-term openness of unstable lesions is 70. What is the benefit of turning into a lesion that is% and has a 30% chance of reocclusion? Recently Before attempts have shown that stents reduce the rate of reocclusion to 10% -20% Also, with large-scale Emory follow-up, patients with and without restenosis So, in the former group, the need for repeated angioplasty or bypass surgery Despite the large value, the same 5-year survival rate of 96% was shown. These data are sudden If the short-term risk of (spontaneous) obstruction is only about 5%, angioplasty It suggests that there are advantages. Example VI: <Medical treatment> Medical treatment depends in part on whether the inflammation is on the surface or under a healthy cap To do. This distinction is that one day, angioscopi (especially using luminescent antibodies) Made by (and) or soluble markers of inflammation (P-selectin, VCAM) -1, and others) by sampling blood. Magnetism Qi resonance imaging, ultrasound, and near infrared imaging may also be useful. Treatment includes monocyte recretion, attachment, activation, or DN Drugs that prevent A synthesis (peptides, peptide mimetics, oligonucleotides) , And others) may be included for local transport. On the contrary, ascorbic acid Rui or conversion growth factor-β, which induces inflammation in non-inflamed tissue Smell in most models, although it can cause endothelium regeneration It also suppresses angiogenesis, inflammation, and smooth muscle growth). Collagen synthesis may be stimulated. Outside Nathan, (JCell Bol) 11 3: 981-986 (1991). Endothelial regeneration by basic or acidic fibroblast growth factors Or it can be enhanced especially by endothelial growth factors of blood vessels. Cascels ls) Outside, Circulation 91: 2699-2702 (1995). In summary, living human carotid atherosclerosis plaques are lumens. Rui has microthermal dysplasia mainly due to macrophages near the lumen doing. These high temperature regions are determined by thermistors and infrared thermography. Can be identified. Hot plaques are actually blood clots (or restenosis (gel)) Outside Hertz, Circulation 92: 1-293 (1995); Outside Moreno, Circulation 92: 1-161 (1995)) Or in the case of adventitial inflammation, there is a high risk of aneurysm rupture If so, imaging and treatment of these potentially life-threatening lesions It is possible to develop catheter-based non-invasive means for this purpose. This Using these techniques, by magnetic resonance imaging, or by endoscopy, ophthalmoscope Subcutaneous inflammation by examination, laparoscopy, indirect microscopy or transcranial imaging Malignant cells in clusters or other organs may be detected. As described above, in order to find and propose a preferable form for carrying out the present invention. The present invention has been described by specific embodiments. Engineers in the field If you read this specification, you can refer to the above-mentioned examples without departing from the scope of the invention. Many modifications and changes will be possible. For example, this invention is an example in biomedicine. As confirmed by, the devices and methods of the present invention are for the weakness of any vascular wall. In the analysis, as long as such weakness has or can have a temperature difference It can be applied in the same way. Therefore, artificial vessels such as conduits are heated from the outside. Then, it can be internally analyzed using the apparatus and method of the present invention. This All such amendments are included in the appended claims.