title: Intima Media Thickness Variability (IMTV) and its association with cerebrovascular events: a novel marker of carotid therosclerosis?
abstract: OBJECTIVE
  Increased intima-media thickness (IMT) is an early marker of atherosclerotic disease and several prospective studies have demonstrated that IMT is a strong predictor of cerebrovascular complications. In this paper we propose a novel method to assess IMT, called "intima media thickness variability" (IMTV) and evaluate its relationship with the development of cerebrovascular events.
  
  
  METHODS
  The study was approved by the local IRB. Twenty consecutive patients underwent ultrasound analysis of the carotid arteries (mean age 68 years; age range 59-81 years). The IMT and IMTV of the 40 carotid vessels was assessed. Bland-Altman statistics were employed to measure the inter-observer variability, and ROC analysis was used to assess the association with cerebrovascular events.
  
  
  RESULTS
  In all cases the ROC area under the curve was higher for IMTV than IMT. There was a statistical significant association between IMTV and cerebrovascular events (P=0.018), but no relationship between IMT and events. The results for inter-observer variability showed a systematic error between 0.04 and 0.08 mm. In the Person Rho correlation analysis in no case a statistical association between IMT and symptoms was detected whereas in 2 cases (observer 1 and observer 2), a statistically significant association between IMTV and symptoms was found.
  
  
  CONCLUSIONS
  Data of this preliminary study suggest that IMTV may represent a powerful method to assess carotid atherosclerotic disease with a significant association to cerebrovascular events.
authors.affiliation: Department of Radiology, Azienda Ospedaliero Universitaria, Italy;
authors.forename: Luca
authors.initials: L
authors.lastname: Saba
authors.forename: Giorgio
authors.initials: G
authors.lastname: Mallarini
authors.forename: Roberto
authors.initials: R
authors.lastname: Sanfilippo
authors.forename: Guang
authors.initials: G
authors.lastname: Zeng
authors.forename: Roberto
authors.initials: R
authors.lastname: Montisci
authors.forename: Jasjit
authors.initials: J
authors.lastname: Suri
keywords: Increased intima-media thickness; carotid atherosclerotic disease; cerebrovascular events; intima media thickness variability