Accuracy of In Vivo Carotid B-Mode Ultrasound Compared With Pathological Analysis

• DOI: 10.1161/01.str.32.7.1520
• Publication Date: 2011-06-17T20:08:03Z
• Authors: Gernot Schulte-Al...; Dirk W. Droste; Szabolcs Felszeghy; Mónika Kellermann; Vasile Popa; Katalin Hegedüs; Csaba Hegedüs; Martina Schmid; László Módis; E. Bernd Ringelstein; László Csiba
• Keywords: Adult; Carotid Artery Diseases; Male; Anatomy, Cross-Sectional; Arteriosclerosis; Carotid Artery, Common; Orvostudományok; Middle Aged; Klinikai orvostudományok; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Tunica Intima; Tunica Media; Aged; Ultrasonography

Background and Purpose —This study aimed to determine the correlation of in vivo ultrasound measurements of intima-media thickening (IMT), lumen diameter, and cross-sectional area of the common carotid artery (CCA) with corresponding measurements obtained by gross pathology and histology.

Methods —Sixty-six moribund neurological patients (mean age 71 years) underwent B-mode ultrasound of the CCA a few days before death. During autopsy, carotid specimens were removed in toto. Carotid arteries were ligated and cannulated for injection of a hydrophilic embedding material under standardized conditions. The carotid bifurcation was frozen and cut manually in 3-mm cross slices. Digital image analysis was carried out to determine the diameter and the cross-sectional area of the frozen slices of the CCA. IMT was assessed by light microscope. Ultrasonic and planimetric data were compared.

Results —Mean measurements of lumen diameter and cross-sectional area were 7.13±1.27 mm and 0.496±0.167 cm 2 , respectively, by ultrasound, and 7.81±1.45 mm and 0.516±0.194 cm 2 , respectively, by planimetric analysis of the unfixed redistended carotid arteries ( R 2 =0.389 and 0.497). The mean IMT was 1.005±0.267 mm by ultrasound and 0.67±0.141 mm histologically, resulting in a mean difference of −31%.

Conclusions —Transcutaneous B-mode ultrasound provides a reliable approach for in vivo measurements of the cross-sectional area and, less exactly, of the lumen diameter of the CCA. Compared with histological results, in vivo ultrasound measurements of the IMT are systematically larger.