Subscribe to RSS
DOI: 10.1055/s-0028-1109187
© Georg Thieme Verlag KG Stuttgart · New York
Measurement of Common Carotid Artery Intima-Media Thickness in Clinical Practice: Comparison of B-Mode and RF-Based Technique
Die Messung der Intima-Media-Dicke der Arteria carotis in der klinischen Praxis: Vergleich zwischen Brightness Mode und einer radiofrequenzbasierten TechnikPublication History
received: 17.9.2008
accepted: 19.1.2009
Publication Date:
18 June 2009 (online)

Zusammenfassung
Ziel: Die Intima-Media-Dicke der Arteria carotis communis (CCA-IMT) wird meist mithilfe von B-Mode-Ultraschallbildern gemessen. Eine andere Möglichkeit der CCA-IMT-Bestimmung basiert auf der Analyse des Radiofrequenzsignals (RF) multipler M-Linien. Material und Methoden: Diese Studie untersucht die Beziehung zwischen der CCA-IMT-Bestimmung mit B-Mode und RF-Analyse sowie die Reproduzierbarkeit beider Methoden bei 136 Patienten, bei denen zuvor kardiovaskuläre Symptome aufgetreten waren. Während derselben Untersuchung wurden wiederholte Messungen der Arteria carotis communis beiderseits durchgeführt, wobei im B-Mode über 10 mm gemittelt wurde und mit der RF-Analyse über 14 mm (12 M-Linien). Ergebnisse: Beide Methoden zeigten eine gute Korrelation (Pearson r = 0,765). Die CCA-IMT war 0,779 ± 0,196 mm für die B-Mode-Methode und 0,734 ± 0,172 mm für die RF-Analyse, wobei die mit B-Mode gemessene CCA-IMT im Vergleich zur RF-Analyse signifikant größer war (gemittelter Unterschied 0,045 mm, Standardabweichung 7.8 μm; t = 5,82; p < 0,001). Nach multivariater Regressionsanalyse waren eine Stenose der Arteria carotis, eine inhomogene CCA-IMT und Diabetes mellitus Prädikatoren für Unterschiede zwischen B-Mode-Messung und RF-Analyse. Die Schwankungen für die CCA-IMT-Bestimmung waren für individuelle Patienten für beide Methoden vergleichbar (0,05 ± 0,04 mm bzw. 0,07 ± 0,05 mm). Schlussfolgerung: Die Bestimmung der CCA-IMT mithilfe von B-Mode und RF-Analyse zeigt eine vergleichbare Reproduzierbarkeit und annehmbare Korrelation, die CCA-IMT-Messung mit der RF-Analyse ergibt jedoch konsistent niedrigere Werte. Die Unterschiede zwischen beiden Methoden beruhen im Wesentlichen auf das Vorhandensein von fortgeschrittenen Formen der Atherosklerose. Zusammenfassend kann gesagt werden, dass beide Methoden zuverlässig für die CCA-IMT Messung in der klinischen Praxis eingesetzt werden können.
Abstract
Purpose: The common carotid artery intima-media thickness (CCA-IMT) is usually measured using B-mode ultrasound images. A different approach for CCA-IMT detection is based on radio frequency (RF) multiple M-line analysis. Materials and Methods: The present study explores the relationship between B-mode and RF measurement of CCA-IMT, as well as the reproducibility of both methods in 136 patients recently diagnosed with cardiovascular disease. Within one session, repeated measurements were made in the distal CCA bilaterally, using the B-mode (averaged over 10 mm) and RF technique (averaging 12 M-lines over 14 mm). Results: The two methods correlate well (Pearson r = 0.765). The CCA-IMT values measured with B-mode and RF were 0.779 ± 0.196 mm and 0.734 ± 0.172 mm, respectively. B-mode CCA-IMT is significantly larger than RF CCA-IMT (mean difference of 0.045 mm, SEM 7.8 μm; t = 5.82; p < 0.001). In the multivariate regression analysis, carotid artery stenosis, inhomogeneous IMT and diabetes mellitus were the main predictors of differences between B-mode and RF CCA-IMT. The intrapatient variation for B-mode and RF-based CCA-IMT is comparable (0.05 ± 0.04 mm and 0.07 ± 0.05 mm, respectively). Conclusion: CCA-IMT values measured with RF and B-mode have similar reproducibility and exhibit acceptable correlation, but RF CCA-IMT is significantly smaller. The difference between both methods is mainly due to advanced atherosclerosis. Hence, both methods can be used reliably to measure CCA-IMT in clinical practice.
Key words
intima-media thickness - carotid artery - B-mode ultrasonography - radiofrequency
References
- 1
Devine P J, Carlson D W, Taylor A J.
Clinical value of carotid intima-media thickness testing.
J Nucl Cardiol.
2006;
13
710-718
MissingFormLabel
- 2
Lorenz M W, Markus H S, Bots M L. et al .
Prediction of clinical cardiovascular events with carotid intima-media thickness:
a systematic review and meta-analysis.
Circulation.
2007;
115
459-467
MissingFormLabel
- 3
Bots M L, Dijk J M, Oren A. et al .
Carotid intima-media thickness, arterial stiffness and risk of cardiovascular disease:
current evidence.
J Hypertens.
2002;
20
2317-2325
MissingFormLabel
- 4
Touboul P J, Hennerici M G, Meairs S. et al .
Mannheim carotid intima-media thickness consensus (2004 – 2006). An update on behalf
of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim,
Germany, 2004, and Brussels, Belgium, 2006.
Cerebrovasc Dis.
2007;
23
75-80
MissingFormLabel
- 5
Hoeks A P, Brands P J, Willigers J M. et al .
Non-invasive measurement of mechanical properties of arteries in health and disease.
Proc Inst Mech Eng.
1999;
213
195-202
MissingFormLabel
- 6
Hoeks A P, Willekes C, Boutouyrie P. et al .
Automated detection of local artery wall thickness based on M-line signal processing.
Ultrasound Med Biol.
1997;
23
1017-1023
MissingFormLabel
- 7
Brands P J, Hoeks A P, Willigers J. et al .
An integrated system for the non-invasive assessment of vessel wall and hemodynamic
properties of large arteries by means of ultrasound.
Eur J Ultrasound.
1999;
9
257-266
MissingFormLabel
- 8
Gamble G, Zorn J, Sanders G. et al .
Estimation of arterial stiffness, compliance, and distensibility from M-mode ultrasound
measurements of the common carotid artery.
Stroke.
1994;
25
11-16
MissingFormLabel
- 9
Willekes C, Hoeks A P, Bots M L. et al .
Evaluation of off-line automated intima-media thickness detection of the common carotid
artery based on M-line signal processing.
Ultrasound Med Biol.
1999;
25
57-64
MissingFormLabel
- 10
Van Bortel L M, Vanmolkot F H, Heijden-Spek J J. et al .
Does B-mode common carotid artery intima-media thickness differ from M-model?.
Ultrasound Med Biol.
2001;
27
1333-1336
MissingFormLabel
- 11
Grant E G, Benson C B, Moneta G L. et al .
Carotid artery stenosis: grayscale and Doppler ultrasound diagnosis –Society of Radiologists
in Ultrasound consensus conference.
Ultrasound Q.
2003;
19
190-198
MissingFormLabel
- 12
Meinders J M, Kornet van der L, Brands P J. et al .
Assessment of local pulse wave velocity in arteries using 2D distension waveforms.
Ultrason Imaging.
2001;
23
199-215
MissingFormLabel
- 13
Hermans M MH, Kooman J P, Brandenburg V. et al .
Spatial inhomogeneity of common carotid artery intima is increased in dialysis patients.
Nephrology Dialysis Transplantation.
2007;
22
1205-1212
MissingFormLabel
- 14
Lin L I.
A concordance correlation coefficient to evaluate reproducibility.
Biometrics.
1989;
45
255-268
MissingFormLabel
- 15
Deyo R A, Diehr P, Patrick D L.
Reproducibility and responsiveness of health status measures. Statistics and strategies
for evaluation.
Control Clin Trials.
1991;
12
142S-158S
MissingFormLabel
- 16
Bland J M, Altman D G.
Statistical methods for assessing agreement between two methods of clinical measurement.
Lancet.
1986;
1
307-310
MissingFormLabel
- 17
Potter K, Reed C J, Green D J. et al .
Ultrasound settings significantly alter arterial lumen and wall thickness measurements.
Cardiovasc Ultrasound.
2008;
6
6
MissingFormLabel
- 18
Bots M L, Hofman A, Grobbee D E.
Increased common carotid intima-media thickness. Adaptive response or a reflection
of atherosclerosis? Findings from the Rotterdam Study.
Stroke.
1997;
28
2442-2447
MissingFormLabel
- 19
Amarenco P, Labreuche J, Lavallee P. et al .
Statins in stroke prevention and carotid atherosclerosis: systematic review and up-to-date
meta-analysis.
Stroke.
2004;
35
2902-2909
MissingFormLabel
- 20
Kiechl S, Willeit J.
The natural course of atherosclerosis. Part I: incidence and progression.
Arterioscler Thromb Vasc Biol.
1999;
19
1484-1490
MissingFormLabel
- 21
Kanters S D, Algra A, Leeuwen M S. et al .
Reproducibility of in vivo carotid intima-media thickness measurements: a review.
Stroke.
1997;
28
665-671
MissingFormLabel
- 22
Bots M L, Mulder P G, Hofman van A. et al .
Reproducibility of carotid vessel wall thickness measurements. The Rotterdam Study.
J Clin Epidemiol.
1994;
47
921-930
MissingFormLabel
- 23
Kanters S D, Elgersma O E, Banga J D. et al .
Reproducibility of measurements of intima-media thickness and distensibility in the
common carotid artery.
Eur J Vasc Endovasc Surg.
1998;
16
28-35
MissingFormLabel
- 24
Touboul P J, Vicaut E, Labreuche J. et al .
Design, baseline characteristics and carotid intima-media thickness reproducibility
in the PARC study.
Cerebrovasc Dis.
2005;
19
57-63
MissingFormLabel
Dr. Floris H. B. M. Schreuder
Department of Clinical Neurophysiology, Maastricht University Medical Centre
PO Box 5800
6202 AZ Maastricht
Netherlands
Phone: 0031/43/3 87 72 72
Fax: 0031/43/3 87 52 65
Email: fschreuder@gmail.com