title: Quantification of the wall inhomogeneity in B-mode sonographic images of the carotid artery.
abstract: OBJECTIVE
  The process of atherosclerosis has been assessed increasingly by sonography in B-mode images of the carotid arteries. Carotid artery atherosclerosis is thought to be associated with major atherosclerotic diseases in other regions of the arterial bed, especially the coronary arteries. In addition to the intima-media thickening as an established surrogate parameter of the atherosclerotic wall process, changes of the sonographic morphologic pattern of the intima-media layer might reflect this process.
  
  
  METHODS
  After automatic identification of the intimal and adventitial boundaries of the distal common carotid artery wall, the gray level inhomogeneity of the circumscribed intima-media area was quantified. Older subjects without cardiovascular disease (mean +/- SD, 66.2 +/- 3.8 years; n = 43) were compared with young subjects without cardiovascular disease (24.4 +/- 5.3 years; n = 34) and patients with manifest coronary artery disease (65.0 +/- 9.2 years; n = 69).
  
  
  RESULTS
  Patients with coronary artery disease had a significantly higher intima-media thickness (0.92 +/- 0.21 mm; P < .05) and wall inhomogeneity (4.56 +/- 0.97; P < .001) than the old group (0.86 +/- 0.15 mm and 3.83 +/- 0.62). Both parameters were lowest in the young group (0.56 +/- 0.05 mm and 2.53 +/- 0.76; P < .05 for both parameters and groups).
  
  
  CONCLUSIONS
  Measurement of gray level wall inhomogeneity of the intima-media layer of the common carotid artery may help discriminate between subjects with high and low atherosclerotic burden and may show age-related changes of the intima-media layer. This new quantitative parameter is thought to reflect the atherosclerotic wall process in addition to the intima-media thickness measurement.
authors.affiliation: Center for Internal Medicine, Department Rehabilitative and Preventative Sports Medicine, Freiburg University Hospital, Hugstetterstrasse 55, 79106 Freiburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Sandrock
authors.forename: Da-Chuan
authors.initials: DC
authors.lastname: Cheng
authors.forename: Daniel
authors.initials: D
authors.lastname: Schmitz
authors.forename: Arno
authors.initials: A
authors.lastname: Schmidt-Trucksäss
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography