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Abstract
B-mode ultrasound is being used to assess carotid atherosclerosis in epidemiological
studies and clinical trials. Recently the interpretation of measurements made from
ultrasound images has been questioned. This study examines the anatomical correlates
of B-mode ultrasound of carotid arteries in vitro and in situ in cadavers. Twenty-seven
segments of human carotid artery were collected at autopsy, pressure perfusion fixed
in buffered 2.5% gluteraldehyde and 4% paraformaldehyde and imaged using an ATL UM-8
(10 MHz single crystal mechanical probe). Each artery was then frozen, sectioned and
stained with van Gieson or elastin van Gieson. The thickness of the intima, media
and adventitia were measured to an accuracy of 0.01 mm from histological sections
using a calibrated eye graticule on a light microscope. Shrinkage artifact induced
by histological preparation was determined to be 7.8%. Digitised ultrasound images
of the artery wall were analysed off-line. The distance from the leading edge of the
first interface (LE1) to the leading edge of the second interface (LE2) was measured using a dedicated programme. LE1-LE2 measurements were correlated against histological measurements corrected for shrinkage.
Mean values for the far wall were: ultrasound LE1-LE2 (0.97 mm, S.D. 0.26), total wall thickness (1.05 mm, S.D. 0.37), adventitia (0.35
mm, S.D. 0.16), media (0.61 mm, S.D. 0.18), intima (0.09 mm, S.D. 0.13). Ultrasound
measurements corresponded best with total wall thickness, rather than elastin or the
intima-media complex. Excision of part of the intima plus media or removal of the
adventitia resulted in a corresponding decrease in the LE1-LE2 distance of the B-mode image. Furthermore, increased wall thickness due to intimal
atherosclerotic thickening correlated well with LE1-LE2 distance of the B-mode images. B-mode images obtained from the carotid arteries in
situ in four cadavers also corresponded best with total wall thickness measured from
histological sections and not with the thickness of the intima plus media. In conclusion,
the LE1-LE2 distance measured on B-mode images of the carotid artery best represents total wall
thickness of intima plus media plus adventitia and not intima plus media alone.
Keywords
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Article info
Publication history
Accepted:
April 1,
1993
Received in revised form:
March 24,
1993
Received:
January 5,
1993
Identification
Copyright
© 1993 Published by Elsevier Inc.