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Ren L, Yan L, Fei X, Luo Y. Intraobserver and Interobserver Consistency Evaluation of Carotid Plaque Volume Measured by Different 3-Dimensional Ultrasound Methods. Ultrasound Q 2023; 39:17-22. [PMID: 36716417 DOI: 10.1097/ruq.0000000000000635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
ABSTRACT This study aims to evaluate the accuracy of the semiautomatic planimetric measurement (SAPM) method and the necessity of manually adjusted boundary measurement in 3-dimensional ultrasound measurement of plaque volume. A total of 50 patients with 82 plaques in the common carotid arteries between December 2020 and March 2021 were included in this study. Two observers measured the 3-dimensional volume of plaque for each patient in 3 different methods (contour tracing method [CTM], SAPM method without manually adjusted boundary [SAPM1], and SAPM method with manually adjusted boundary [SAPM2]). The difference in measurement time between the 3 methods was evaluated by Kruskal-Wallis H test. Intraclass correlation coefficient and 95% confidence interval were used to evaluate the intraobserver and interobserver reliability of the 3 measurement modes. The Bland-Altman analysis was used to assess the agreement, which was expressed as the mean difference with the 95% limits of agreement (LOA). The difference in measurement time between the 3 methods was statistically significant ( P < 0.001). Both observers' intraobserver and interobserver reliability showed well in the 3 methods (all of the intraclass correlation coefficients were >0.75). The mean differences of the plaque volume measurement were 38.17, 26.42, and 11.75 mm 3 , respectively. The agreement between CTM and SAPM2 was the best, and LOA was -57.00 to 80.51. The agreement between SAPM1 and SAPM2 and the agreement between SAPM1 and CTM were similar, and the LOAs were -126.10 to 202.40 and -158.00 to 210.80, respectively. The SAPM method may be recommended to measure plaque volume in clinical practice.
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Affiliation(s)
| | - Lin Yan
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Haidian District, Beijing
| | - Xiang Fei
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Haidian District, Beijing
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Lertratanakul A, Sun J, Wu PW, Lee J, Dyer A, Pearce W, McPherson D, Sutton-Tyrrell K, Thompson T, Barinas-Mitchell E, Ramsey-Goldman R. Risk factors for changes in carotid intima media thickness and plaque over 5 years in women with systemic lupus erythematosus. Lupus Sci Med 2021; 8:8/1/e000548. [PMID: 34876504 PMCID: PMC8655565 DOI: 10.1136/lupus-2021-000548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/19/2022]
Abstract
Objective To investigate the occurrence of and risk factors for progression of carotid intima media thickness (IMT) and plaque in women with and without SLE. Methods A cohort of 149 women with SLE and 126 controls participated in SOLVABLE (Study of Lupus Vascular and Bone Long-term Endpoints). Demographics, cardiovascular and SLE factors, and laboratory assessments were collected at baseline. Carotid IMT and plaque were measured using B-mode ultrasound at baseline and at 5-year follow-up. Regression models were used to identify predictors of progression in carotid IMT and plaque; multivariate models were adjusted for age, hypertension and total cholesterol to high-density lipoprotein ratio. Results The mean±SD follow-up time was 5.35±0.60 years in cases and 5.62±0.66 years in controls. The mean IMT change per year was 0.008±0.015 mm in cases and 0.005±0.019 mm in controls (p=0.24). At follow-up, 31.5% of cases and 15% of controls had plaque progression, with a relative risk for plaque progression of 2.09 (95% CI 1.30 to 3.37). In SLE cases, higher fasting glucose and lower fibrinogen were associated with IMT progression after adjustment. Larger waist circumference and non-use of hydroxychloroquine were associated with plaque progression after adjustment. Conclusion Potential modifiable risk factors for carotid IMT and plaque progression in women with SLE were identified, suggesting that monitoring of glucose and waist circumference and use of hydroxychloroquine may be beneficial.
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Affiliation(s)
- Apinya Lertratanakul
- Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Julia Sun
- Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Peggy W Wu
- Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jungwha Lee
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alan Dyer
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - William Pearce
- Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David McPherson
- Cardiology, University of Texas McGovern Medical School, Houston, Texas, USA
| | | | - Trina Thompson
- Ultrasound Research Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Emma Barinas-Mitchell
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Saba L, Yuan C, Hatsukami TS, Balu N, Qiao Y, DeMarco JK, Saam T, Moody AR, Li D, Matouk CC, Johnson MH, Jäger HR, Mossa-Basha M, Kooi ME, Fan Z, Saloner D, Wintermark M, Mikulis DJ, Wasserman BA. Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology. AJNR Am J Neuroradiol 2018; 39:E9-E31. [PMID: 29326139 DOI: 10.3174/ajnr.a5488] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Identification of carotid artery atherosclerosis is conventionally based on measurements of luminal stenosis and surface irregularities using in vivo imaging techniques including sonography, CT and MR angiography, and digital subtraction angiography. However, histopathologic studies demonstrate considerable differences between plaques with identical degrees of stenosis and indicate that certain plaque features are associated with increased risk for ischemic events. The ability to look beyond the lumen using highly developed vessel wall imaging methods to identify plaque vulnerable to disruption has prompted an active debate as to whether a paradigm shift is needed to move away from relying on measurements of luminal stenosis for gauging the risk of ischemic injury. Further evaluation in randomized clinical trials will help to better define the exact role of plaque imaging in clinical decision-making. However, current carotid vessel wall imaging techniques can be informative. The goal of this article is to present the perspective of the ASNR Vessel Wall Imaging Study Group as it relates to the current status of arterial wall imaging in carotid artery disease.
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Affiliation(s)
- L Saba
- From the Department of Medical Imaging (L.S.), University of Cagliari, Cagliari, Italy
| | - C Yuan
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - T S Hatsukami
- Surgery (T.S.H.), University of Washington, Seattle, Washington
| | - N Balu
- Departments of Radiology (C.Y., N.B., M.M.-B.)
| | - Y Qiao
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
| | - J K DeMarco
- Department of Radiology (J.K.D.), Walter Reed National Military Medical Center, Bethesda, Maryland
| | - T Saam
- Department of Radiology (T.S.), Ludwig-Maximilian University Hospital, Munich, Germany
| | - A R Moody
- Department of Medical Imaging (A.R.M.), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Li
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - C C Matouk
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.)
| | - M H Johnson
- Departments of Neurosurgery, Neurovascular and Stroke Programs (C.C.M., M.H.J.).,Radiology and Biomedical Imaging (C.C.M., M.H.J.).,Surgery (M.H.J.), Yale University School of Medicine, New Haven, Connecticut
| | - H R Jäger
- Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, London, UK
| | | | - M E Kooi
- Department of Radiology (M.E.K.), CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Z Fan
- Biomedical Imaging Research Institute (D.L., Z.F.), Cedars-Sinai Medical Center, Los Angeles, California
| | - D Saloner
- Department of Radiology and Biomedical Imaging (D.S.), University of California, San Francisco, California
| | - M Wintermark
- Department of Radiology (M.W.), Neuroradiology Division, Stanford University, Stanford, California
| | - D J Mikulis
- Division of Neuroradiology (D.J.M.), Department of Medical Imaging, University Health Network
| | - B A Wasserman
- The Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital, Baltimore, Maryland
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Filipiak-Strzecka D, Kasprzak JD, Szymczyk E, Wejner-Mik P, Lipiec P. Bedside screening with the use of pocket-size imaging device can be useful for ruling out carotid artery stenosis in patients scheduled for cardiac surgery. Echocardiography 2017; 34:716-722. [PMID: 28299809 DOI: 10.1111/echo.13507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients (pts) scheduled for coronary artery bypass grafting, burdened with high risk of carotid stenosis, are recommended to undergo duplex ultrasonography (DUS) of carotid arteries. PURPOSE To validate pocket-size imaging device (PSID) equipped with linear probe as an easily accessible tool enabling bedside screening for carotid artery stenosis (CAS). METHODS A total of 100 pts (60 men, mean age 69±11 years) with multivessel coronary artery disease underwent bedside DUS of carotid arteries with the use of PSID performed by a cardiology resident trained in DUS. Subsequently, DUS with the use of stationary high-end ultrasound system was performed in all pts to verify findings of PSID examination. RESULTS Initial diagnosis of atherosclerotic plaque presence obtained with PSID in 59 patients was confirmed by high-end ultrasound system examination in all cases. There was a statistically significant correlation of intima-media thickness measurements between PSID and stationary system (r=.58; 95% CI: 0.48-0.66; P<.0001), but the coefficient of agreement (κ) between the two methods in classification of intima-media as normal or thickened (>0.9 mm) was only .38 (95% CI: 0.299-0.459). During PSID examination, turbulent flow was observed in 21 pts-CAS was confirmed in all these pts-5 pts were diagnosed with significant CAS, the rest with CAS ranging from 30% to 70%. CONCLUSIONS Pocket-size imaging device equipped with linear probe allows for identification of patients with atherosclerotic plaques and turbulent flow in carotid arteries; however, the degree of CAS cannot be reliably determined. The measurement accuracy of intima-media thickness is insufficient for a diagnostic purpose.
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Affiliation(s)
| | - Jarosław D Kasprzak
- Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland
| | - Ewa Szymczyk
- Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland
| | - Paulina Wejner-Mik
- Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland
| | - Piotr Lipiec
- Department of Cardiology, Bieganski Hospital, Medical University of Lodz, Lodz, Poland
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Vlachojannis C, Erne P, Schoenenberger AW, Chrubasik-Hausmann S. A Critical Evaluation of the Clinical Evidence for Pomegranate Preparations in the Prevention and Treatment of Cardiovascular Diseases. Phytother Res 2015; 29:501-8. [DOI: 10.1002/ptr.5280] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/26/2014] [Accepted: 12/02/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Christian Vlachojannis
- Institute of Forensic Medicine; University of Freiburg; Albertstr. 9 79104 Freiburg Germany
| | - Paul Erne
- Hirslanden Klinik St. Anna; St. Annastr. 32 CH 6006 Luzern Switzerland
| | - Andreas W. Schoenenberger
- Division of Geriatrics, Department of General Internal Medicine, Inselspital, Bern University Hospital; University of Bern; 3010 Bern Switzerland
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