title: Changes in the textural characteristics of intima-media complex in young patients with familial hypercholesterolemia: implication for visual inspection on B-mode ultrasound.
abstract: BACKGROUND
  To test the hypothesis that textural changes in the carotid intima-media complex (IMC) on visual inspection by B-mode ultrasound are associated with early atherosclerotic involvement in patients with heterozygous familial hypercholesterolemia (FH).
  
  
  METHODS
  55 patients (mean age 13.4 years) were categorized into three groups according to the degree of thickness in IMC (intima-media thickness [IMT]) (groups I-III) and 15 healthy controls within the same age range as the patients were assessed for first- and second-order statistics and visual scoring of textural changes in IMC (1, normal; 2, proximal interface disruption; 3, granulation).
  
  
  RESULTS
  There was no significant difference in first-order statistics among the four groups. As for second-order statistics, groups II (moderately increased IMT) and III (markedly increased IMT) had significantly higher entropy and lower angular second moment than group I (normal IMT) and control. Likewise, groups II and III received significantly higher visual scoring than group I. Visual scoring correlated with entropy (r = 0.57) and angular second moment (r = -0.50). Multiple regression analysis identified entropy (beta = 0.52) and visual scoring (beta = 0.42) as significant determinants of IMT.
  
  
  CONCLUSIONS
  These findings demonstrate that higher visual scoring may indicate dishomogeneity of IMC, suggesting early medial infiltration. This seems to be a simple visual marker to more effectively identify high-risk young patients with FH.
authors.affiliation: Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan. info@noto-clinic.com
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Noto
authors.forename: Tomoo
authors.initials: T
authors.lastname: Okada
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Abe
authors.forename: Michio
authors.initials: M
authors.lastname: Miyashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanamaru
authors.forename: Kensuke
authors.initials: K
authors.lastname: Karasawa
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ayusawa
authors.forename: Naokata
authors.initials: N
authors.lastname: Sumitomo
authors.forename: Hideo
authors.initials: H
authors.lastname: Mugishima
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000000981:diagnostic imaging*; D008297:Male; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography