Evaluation of a new carotid intima-media thickness measurement by B-mode ultrasonography using an innovative measurement software, intimascope (original) (raw)
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B-mode ultrasonography is a diagnostic method which allows measurement of intima-media thickness (IMT) at the level of the carotid artery and femoral artery. The relationship between the common carotid artery (CCA) IMT and coronary artery disease, the changes in the IMT after drug therapy and its relation with heart attack and sudden death risk, the association between the IMT and systemic diseases mainly diabetes mellitus, hypercholesterolemia and hyperten-sion all had been investigated by many researchers (1-6). As pointed out by the collected data to date, measurement of IMT by ultrasonography has become a morphological criterion for the detection of atherosclero-sis. Manual measurement methods are generally used to measure the IMT values sonographically but results show variations secondary to subjective parameters when manual measurement methods are employed (7). Additionally studies have demonstrated that CCA IMT values may show interobserver variability in repeated measurements (8, 9). To decrease the interobserver variability during the IMT measurements computer software programs were developed which allow automated measurements. The aim of this study is to determine whether a correlation exists between the manual and computer assisted IMT measurements of CCA. Materials and methods A total of 88 patients were included the study which consisted of 39 males and 49 females (mean age, 37.7 years) who were referred for ultra-sonographic IMT analysis of the carotid artery. The study was conducted between January 2004 and June 2004 and consisted of selected cases from the archives in which the cases were either part of various studies conducted to measure IMT thickness in situations where IMT thickness were expected to increase or were normal cases which formed the control groups of these studies. Ultrasonographic images of the right and the left CCA of each case at the lower 1/3 cervical region proximally and 1 cm above the carotid bulb distally in longitudinal plane were obtained digitally and archived in the PACS system utilizing a sonography device with a high definition L12-5 linear wide band probe (Philips HDI 5000, Both-ell, WA, USA). Care was taken to keep the frequency level and other imaging parameters (general 2D optimization, low persistency) the same in each patient. Archived images were analyzed retrospectively in a blinded fashion by two investigators using a PACS workstation separately. CCA IMT measurements of the proximal and distal CCA posterior wall were done manually by the provided distance measurement system of the sonography device after magnification of the images (Figure 1). The two investigators measuring manually used the grading method from the ARIC (atherosclerosis risk in community) study and three measurements were made in a non-neighboring fashion within an approximately 1 cm PURPOSE Intima-media thickness (IMT) has been proposed to be a morphological criterion of atherosclerosis. The purpose of this study was to investigate the inter-observer variability of manual and also of computer software measurements of IMT. MATERIALS AND METHODS High-resolution common carotid artery (CCA) images of 88 patients that have been obtained by a linear broadband L5-12 MHz transducer and archived in PACS were retrospectively evaluated. Two separate investigators, who were unaware of the former results , evaluated the same images by using computer software that had a dedicated tool for automatic measurement of IMT. The results of the investigators were compared. RESULTS According to the two investigators who have performed manual measurements, mean values of IMT of right CCA were 0.6396 mm and 0.6356 mm; of the left CCA were 0.6662 mm and 0.6575 mm, respectively. The interobserver variability of measurements revealed the mean IMT as 0.6071 mm and 0.6048 mm for the right, 0.6216 mm and 0.6227 mm for the left CCA. Manual measurements of both investigators were found to be higher than the automatic measurements and the differences were statistically significant. Interobserver correlation of manual measurements was between 0.80-0.88 and of the automated measurements was between 0.93-0.98. CONCLUSION Manual measurements reveal higher values than the automated measurements of IMT. The interobserver correlation of automated measurements is higher than manual measurements. The use of dedicated software may be proposed to reduce the measurement errors.
Archives of Medical Sciences. Atherosclerotic Diseases, 2020
Introduction Cardiovascular diseases (CVD) are the main cause of premature deaths worldwide, and atherosclerosis (AS) is a major risk factor associated with them. B-mode ultrasound is a well-validated research tool that has been translated increasingly into clinical practice. The aim of the study was to assess the diagnostic accuracy of carotid intima media thickness by B-mode ultrasonography in coronary artery disease patients. Material and methods This was a case control study, including 100 cases and the same number of controls. Patients with positive angiographic findings and chest pain were considered as cases and those without as negative. Duplex carotid ultrasound was used to detect intima-media thickness (IMT). B-mode real-time ultrasonic images were obtained with a 7 MHz transducer. An intima media thickness of 0.6 mm was considered as being without plaque. Results The angiographic findings were single-vessel disease, double-vessel disease, and triple-vessel disease in 18%,...
Folia morphologica, 2003
The intima-media thickness (IMT) of carotid arteries was demonstrated to be a reliable measure for early stages of atherosclerosis. B-mode ultrasound may be used to measure carotid IMT. The measurements of the IMT of the carotid artery (CA) conducted by different investigators can be comparable and enable the implementation of clinical trial successfully while maintaining a high reproducibility value. The objective of the study was to evaluate the reproducibility of the measurements made by the same investigator on two separate occasions (intraobserver variability) and the reproducibility of the off-line measurements between four sonographers in our laboratory (interobserver variability). The IMT of CA in 25 subjects (15 post stroke and 10 healthy persons) was investigated with the use of high-resolution ultrasonography. The CA subdivided into the common, bulbs and internal segments were scanned twice with a 3-week interval. Additionally three other readers with different levels of ...
Diagnostic and interventional radiology (Ankara, Turkey), 2005
Intima-media thickness (IMT) has been proposed to be a morphological criterion of atherosclerosis. The purpose of this study was to investigate the interobserver variability of manual and also of computer software measurements of IMT. High-resolution common carotid artery (CCA) images of 88 patients that have been obtained by a linear broadband L5-12 MHz transducer and archived in PACS were retrospectively evaluated. Two separate investigators, who were unaware of the former results, evaluated the same images by using computer software that had a dedicated tool for automatic measurement of IMT. The results of the investigators were compared. According to the two investigators who have performed manual measurements, mean values of IMT of right CCA were 0.6396 mm and 0.6356 mm; of the left CCA were 0.6662 mm and 0.6575 mm, respectively. The interobserver variability of measurements revealed the mean IMT as 0.6071 mm and 0.6048 mm for the right, 0.6216 mm and 0.6227 mm for the left CCA...
Background and Purpose-The intima-media thickness (IMT) of extracranial carotid arteries determined by B-mode ultrasound is a measurable index of the presence of atherosclerosis. The ultrasonographic scan protocol and the scan reading techniques used until now to measure IMT are, however, time consuming and require the participation of specialized research centers. In this study we present a cross-sectional study of 963 patients attending the Enrica Grossi Paoletti Center in Milan, Italy, with the aim of assessing whether ultrasonographic measurements of carotid artery in routine clinical practice can yield the same results as those obtained with quantitative methods used until now in clinical trials. Methods-Maximum and mean maximum IMT of carotid arteries were assessed by B-mode ultrasound with the use of the electronic caliper of the machine in real time. Results-The intraobserver and interobserver variability of IMT of carotid arteries performed with the electronic caliper in real time was similar to that of quantitative processing of frozen images (coefficients of variation of intraobserver and interobserver mean maximum IMT measurements were 4.2% and 7.3%, respectively). Carotid artery IMT thus measured correlated with most of the known atherosclerosis risk factors and discriminated between patients with and without previous history of cardiovascular events. IMT was linearly related to the total number of vascular risk factors both in the whole group and after stratification of patients into 3 age classes.
Journal of the Anatomical Society of India, 2014
Introduction: Carotid intima-media thickness (CIMT) testing has emerged as a valuable tool for detecting atherosclerosis. Its relationships with coronary artery disease risk factors, future cardiovascular events, allow it to serve as a suitable diagnosing method for coronary atherosclerosis. The purpose of this study was to investigate the CIMT detected by Ultrasonography as a clinically useful marker for the presence and severity of coronary artery disease (CAD). Materials and Methods: Two hundred consecutive patients (age from 30 ye80 y) who were subjected to coronary angiography also subjected for carotid B-mode ultrasound scan of carotid artery. The mean value of six measurements of IMT of far wall of the common carotid artery and at its bifurcation was calculated in each patient. Result: The mean IMT was significantly correlated to the number of stenosed coronary arteries. The mean CIMT in patients with single vessel disease, double vessel disease and for triple vessel disease was 0.580 ± 0.160 mm, 0.718 ± 0.206 mm and 0.934 ± 0.301 mm respectively, which was higher as compared to control group (0.465 ± 0.144 mm). Discussion: A significant linear correlation between IMT and advancing CAD observed by A Kablak-Ziembicka. Daniel H. O'Leary has reported the prevalence and severity of carotid atherosclerosis continued to increase with age even in the late decades of life. In the present study IMT thickness was increased with age and mean CIMT was found greater for significant CAD as compared to non-significant CAD and for normal coronary arteries thus CIMT may be a clinically valuable parameter in diagnosis of non-significant and significant CAD.
An update on carotid ultrasound measurement of intima-media thickness. Discussion
The American Journal of Cardiology, 2002
Coronary atherosclerosis is a chronic, multifactorial disease process. Some individuals with atherosclerosis receive treatment in the form of mechanical or pharmacologic interventions after an acute event has occurred. Others receive treatment in the form of risk factor-based systemic intervention, the effectiveness of which is assessed by its ability to prevent an acute event. Surrogate endpoints in the study of atherosclerosis interventions are needed to better define disease course and disease response to interventions during the prolonged asymp-tomatic period. Several techniques for assessing arterial health are available, including quantitative intimamedia thickness (QIMT) measurement by carotid ultrasound. QIMT is a safe, validated, and portable method that may prove highly useful in screening for atherosclerosis and in providing a surrogate measure for response to disease interventions. ᮊ2002 by Excerpta Medica, Inc.
Journal of the American Society of Echocardiography, 2008
Background: Carotid intima-media thickness (IMT) is a surrogate marker of atherosclereosis and imparts prognostic information independent of traditional cardiovascular risk factors. Quantitative assessment of IMT using semiautomated border detection software is a new and easy technique that has been previously shown to be accurate, effective, and reproducible. The study is aimed to define the upper limit of carotid IMT at the common carotid artery (CCA) and its bifurcation among a healthy population in the United Kingdom.
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2008
Carotid intima-media thickness (IMT) is a surrogate marker of atherosclerosis and imparts prognostic information independent of traditional cardiovascular risk factors. Quantitative assessment of IMT using semiautomated border detection software is a new and easy technique that has been previously shown to be accurate, effective, and reproducible. The study is aimed to define the upper limit of carotid IMT at the common carotid artery (CCA) and its bifurcation among a healthy population in the United Kingdom. Asymptomatic men and women aged 35 to 75 years, without evidence of clinical atherosclerosis, underwent B-mode carotid duplex ultrasound (Sonos 7500, Philips, Best, The Netherlands). Mean carotid IMT at the far wall of both left and right CCA were quantitatively determined using a semiautomated edge-detection algorithm (Q-lab 4, Philips). Healthy population was defined as participants with no cardiovascular disease and no evidence of diabetes mellitus or hypertension with a bod...