title: High Spatial Inhomogeneity in the Intima-Media Thickness of the Common Carotid Artery is Associated with a Larger Degree of Stenosis in the Internal Carotid Artery: The PARISK Study.
abstract: PurposeInhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA).Materials and MethodsWe included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter.Results182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors.ConclusionRegardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.
authors.affiliation: Biomedical Engineering, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Jeire
authors.initials: J
authors.lastname: Steinbuch
authors.affiliation: Radiology, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Anouk C
authors.initials: AC
authors.lastname: van Dijk
authors.affiliation: Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Floris H B M
authors.initials: FHBM
authors.lastname: Schreuder
authors.affiliation: Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Martine T B
authors.initials: MTB
authors.lastname: Truijman
authors.affiliation: Radiology, University Medical Center Utrecht, Netherlands.
authors.forename: Alexandra A J
authors.initials: AAJ
authors.lastname: de Rotte
authors.affiliation: Neurology, Academic Medical Center Amsterdam, Netherlands.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nederkoorn
authors.affiliation: Radiology, Erasmus MC, Rotterdam, Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: Radiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Hermeling
authors.affiliation: Biomedical Engineering, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Arnold P G
authors.initials: APG
authors.lastname: Hoeks
authors.affiliation: Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Werner H
authors.initials: WH
authors.lastname: Mess
mesh_terms: D017536:Carotid Artery, Common; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic; D006801:Humans; D012307:Risk Factors; D017540:Tunica Media