A practical protocol to measure common carotid artery intima-media thickness.
OBJECTIVE
To describe and test a practical protocol to measure common carotid intima-media thickness that uses the combined values of two longitudinal examination angles to increase sensitivity.


METHODS
Between February and September 2005, 206 patients underwent duplex scan examination of carotid vessels, and the intima-media thickness of 407 common carotids were measured in three angles: transversal, longitudinal posterolateral, and anterolateral, with three intima-media thickness measurements for each near and far wall. In addition to numbers obtained from the three angles of measurement, a fourth visual perspective was obtained by combining the intima-media thickness results of posterolateral and anterolateral longitudinal views and considering the thickest wall measurement.


RESULTS
Two hundred seventy (66.3%) carotid arteries had an intima-media thickness thicker than 1mm. The mean intima-media thickness values achieved by the different incidences were 1.26+/-0.6 mm (transversal), 1.17+/-0.54 mm (longitudinal anterolateral), and 1.18+/-0.58 mm (longitudinal posterolateral). A significant difference in intima-media thickness measurement values was observed when the three angles of examination plus the combined positive results of both longitudinal angles were compared by ANOVA (P=0.005). The LSD Post-Hoc test determined that the combined longitudinal view results were similar to the transversal views (P=0.28) and had greater intima-media thickness means than isolated anterolateral or posterolateral longitudinal views (P=0.02 and 0.05, respectively).


CONCLUSIONS
The protocol presented is a practical method for obtaining common carotid artery intima-media thickness measurements. The combined longitudinal posterolateral and anterolateral longitudinal views provide a more sensitive evaluation of the inner layers of the carotid walls than isolated longitudinal views.
Casella
Ivan Benaduce
IB
Division of Vascular Surgery, Hospital Regional Sul, São Paulo, SP, Brazil. ivancasel@uol.com.br
Presti
Calógero
C
Porta
Rina Maria Pereira
RM
Sabbag
Cláudio Rogério Donmarco
CR
Bosch
Maria Alice
MA
Yamazaki
Yumiko
Y
D000328:Adult; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology; D018616:Ultrasonography, Doppler, Duplex