B-mode ultrasound images of the carotid artery wall: correlation of ultrasound with histological measurements

doi:10.1016/0021-9150(93)90158-Q

Atherosclerosis

Volume 102, Issue 2, September 1993, Pages 163-173

https://doi.org/10.1016/0021-9150(93)90158-Q Get rights and content

Abstract

B-mode ultrasound is being used to assess carotid atherosclerosis in epidemiological studies and clinical trials. Recently the interpretation of measurements made from ultrasound images has been questioned. This study examines the anatomical correlates of B-mode ultrasound of carotid arteries in vitro and in situ in cadavers. Twenty-seven segments of human carotid artery were collected at autopsy, pressure perfusion fixed in buffered 2.5% gluteraldehyde and 4% paraformaldehyde and imaged using an ATL UM-8 (10 MHz single crystal mechanical probe). Each artery was then frozen, sectioned and stained with van Gieson or elastin van Gieson. The thickness of the intima, media and adventitia were measured to an accuracy of 0.01 mm from histological sections using a calibrated eye graticule on a light microscope. Shrinkage artifact induced by histological preparation was determined to be 7.8%. Digitised ultrasound images of the artery wall were analysed off-line. The distance from the leading edge of the first interface (LE₁) to the leading edge of the second interface (LE₂) was measured using a dedicated programme. LE₁-LE₂ measurements were correlated against histological measurements corrected for shrinkage. Mean values for the far wall were: ultrasound LE₁-LE₂ (0.97 mm, S.D. 0.26), total wall thickness (1.05 mm, S.D. 0.37), adventitia (0.35 mm, S.D. 0.16), media (0.61 mm, S.D. 0.18), intima (0.09 mm, S.D. 0.13). Ultrasound measurements corresponded best with total wall thickness, rather than elastin or the intima-media complex. Excision of part of the intima plus media or removal of the adventitia resulted in a corresponding decrease in the LE₁-LE₂ distance of the B-mode image. Furthermore, increased wall thickness due to intimal atherosclerotic thickening correlated well with LE₁-LE₂ distance of the B-mode images. B-mode images obtained from the carotid arteries in situ in four cadavers also corresponded best with total wall thickness measured from histological sections and not with the thickness of the intima plus media. In conclusion, the LE₁-LE₂ distance measured on B-mode images of the carotid artery best represents total wall thickness of intima plus media plus adventitia and not intima plus media alone.

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Research paperB-mode ultrasound images of the carotid artery wall: correlation of ultrasound with histological measurements

Abstract

Ultrasound Med. Biol.

Atherosclerosis

Atherosclerosis

Am. J. Med.

Am. Heart J.

J. Int. Med.

Atherosclerosis

Reliability of B-mode ultrasound in measuring small carotid artery plaques

Circulation

Relation of extent of extracranialcarotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis

Arterioscler. Thromb.

Risk factors for extracranial carotid artery atherosclerosis

Stroke

Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis, a case-control study

Circulation

Ultrasonographically assessed carotid morphology and the risk of coronary heart disease

Arterioscler. Thromb.

Assessment of Ultrasound Bmode Imaging for Detection and Quantification of Atherosclerotic Lesions in Arteries of Animals

Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging

Circulation

Detection and monitoring of asymptomatic atherosclerosis in clinical trials

Am. J. Med.

The multicenter isradipine/diuretic atherosclerosis study: a study of the antiatherogenic properties of isradipine in hypertensive patients

J. Cardiol. Pharm.

The aortic wall: an in vitro study of the double-line pattern in high-resolution US

Radiology

Research paper
B-mode ultrasound images of the carotid artery wall: correlation of ultrasound with histological measurements