title: Carotid ultrasound phenotypes in vulnerable populations.
abstract: BACKGROUND
  Biomarkers of carotid atherosclerosis range from those that are widely available and relatively simple to measure such as serum cholesterol levels, and B-mode Ultrasound measurement of intima media thickness (IMT) to those that are more complex and technologically demanding but perhaps potentially more sensitive and specific to disease such as total plaque volume and total plaque area measured from 3-dimensional ultrasound images. In this study we measured and compared intima media thickness (IMT), total plaque volume (TPV) and total plaque area (TPA) in two separate populations, both vulnerable to carotid atherosclerosis.
  
  
  METHODS
  In total, 88 subjects (mean age 72.8) with carotid stenosis of at least 60%, based on a peak Doppler flow, and 82 subjects (mean age 60.9) with diabetic nephropathy were assessed in a cross-sectional study. Conventional atherosclerotic risk factors were examined and the associations and correlations between these and carotid ultrasound phenotypes measured from B-mode and 3-dimensional ultrasound images were assessed.
  
  
  RESULTS
  IMT and TPV were only modestly correlated in the two separate populations (r = .6, p < .01). ANOVA analyses indicated that both IMT and TPV were significantly associated with age (p < .001) and Framingham score (p < .05), but only TPV was associated with diabetes (p < .001) and presence of plaque ulcerations (p < .01)
  
  
  CONCLUSIONS
  IMT and TPV were modestly correlated in a diabetic patient population and only TPV was associated with diabetes and the presence of plaque ulcerations in a diabetic population and carotid stenosis group. The 3-dimensional information provided by TPV can be critically important in unmasking association with risk factors not observed with less complex single-dimension assessments of carotid atherosclerosis such as those provided by IMT.
authors.affiliation: Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, London, Ontario, N6A 5K8, Canada. riccio@interchange.ubc.ca
authors.forename: Silvia A
authors.initials: SA
authors.lastname: Riccio
authors.forename: Andrew A
authors.initials: AA
authors.lastname: House
authors.forename: J David
authors.initials: JD
authors.lastname: Spence
authors.forename: Aaron
authors.initials: A
authors.lastname: Fenster
authors.forename: Grace
authors.initials: G
authors.lastname: Parraga
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D003928:Diabetic Nephropathies / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D010641:Phenotype; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*