Effect of contrast enhancement on measurement of carotid artery intimal medial thickness
Effect of contrast enhancement on measurement of carotid artery intimal medial thickness
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DOI：
10.1191/1358863x04vm522oa
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发表时间：
2004-01-01
影响因子：
3.5
通讯作者：
Feinstein, SB
中科院分区：
文献类型：
--
作者：
Macioch, JE;Katsamakis, CD;Feinstein, SB
以前的研究使用标准的B型超声来量化颈总动脉(CCA)近壁和远壁的总平均内中膜厚度(IMT)。由于难以辨别血管管腔和内膜，许多研究人员难以准确评估近壁IMT。本研究的目的是确定对比增强图像和非增强图像对IMT测量的影响。对26名在6个月内完成标准颈动脉超声检查的患者进行了评估，其中24名患者由同一超声师进行了成像。在颈动脉分叉近端0.5 cm和近端1.5 cm处，在1 cm的距离内测量近壁和远壁的5到6个测量值。测量是在使用和不使用对比剂Optison(TM)(全氟特伦蛋白A型微球)的情况下进行的，该造影剂以静脉推注(0.5-0.7毫升)的形式给药。在同一超声仪的成像中，检查了40条颈动脉，总共获得了867条测量值。在最初的解释后大约1个月，总共对10%的颈动脉超声进行了重新研究，以评估观察者的准确性。近壁颈总动脉平均(SD)内中膜厚度(SD)左侧为0.075(0.019)cm，左侧为0.067(0.023)cm，右侧为0.089(0.024)cm，右侧为0.071(0.022)cm，P<0.0001。颈总动脉远端壁的平均(SD)内中膜厚度比较，左侧为0.075(0.021)cm，左侧为0.070(0.016)cm，P=0.005；右侧为0.070(0.023)cm，右侧为0.070(0.016)cm，P=0.68。总而言之，对比增强IMT测量结果显示，颈动脉壁厚度测量结果与非造影值相比有非常显著的统计学差异。更厚的测量值与先前报道的数据一致，这些数据表明，在组织学样本中，非对比图像低估了近壁颈总动脉IMT。
Previous studies have used standard B-mode ultrasound to quantify the aggregate mean intimal medial thickness (IMT) of the near and far wall of the common carotid artery (CCA). Many investigators have had difficulty in accurately evaluating the near wall IMT secondary to difficulty in discerning the vessel lumen and intima. The purpose of this study is to determine the effect of contrast enhanced ultrasound on IMT measurement when compared with non-enhanced images. Twenty-six patients who had standard carotid ultrasounds completed over a 6-month period were evaluated, with 24 imaged by the same sonographer. Five to six measurements of the near and far walls were obtained over a 1 cm distance, beginning and ending 0.5 cm and 1.5 cm proximal to the carotid bifurcation. The measurements were made with and without the contrast agent Optison(TM) (perflutren protein type-A microspheres), which was given as an IV bolus ( 0.5 - 0.7 cc). Of those imaged by the same sonographer, 40 carotid arteries were examined and a total of 867 measurements were obtained. A total of 10% of the carotid ultrasounds were restudied approximately 1 month after the initial interpretation to assess observer accuracy. The near wall CCA mean (SD) IMT was 0.075 (0.019) cm for left with contrast versus 0.067 (0.023) cm for left without contrast and 0.089 (0.024) cm for right with versus 0.071 (0.022) cm for right without, p less than or equal to 0.0001 both sides. For the far wall of the CCA, the mean ( SD) IMT comparison was 0.075 (0.021) cm for left with versus 0.070 (0.016) cm for left without, p = 0.005, and 0.070 ( 0.023) cm for right with versus 0.070 ( 0.016) cm for right without, p = 0.68. In conclusion, contrast-enhanced IMT measurement showed a highly statistically significant difference in near carotid wall thickness determinations versus non-contrast values. The thicker measurement is in agreement with previously reported data showing that non-contrast images underestimated near wall common carotid IMT in histologic samples.