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Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

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Scatter plot showing a strong linear relationship between arterial diameters measured manually (Dmanual) and using our method (Dauto).
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Figure 8: Scatter plot showing a strong linear relationship between arterial diameters measured manually (Dmanual) and using our method (Dauto).

Mentions: Our assessment of reproducibility showed mean intra-observer coefficients of variation of 1.0%, 1.2%, 11.7%, and 12.4% for the measurement of the systolic diameters, diastolic diameters, absolute systolic diameter changes, and percentage diameter changes, respectively. Comparison against manual measurements showed a mean difference in diameter measurements between the two techniques of −0.016 mm (Figure 7) which did not differ significantly from zero (p = 0.06, t-test). The 95% limits of agreement were −0.29 mm to 0.26 mm. Linear regression analysis showed a strong correlation between the measurements made using the two methods (R2 = 0.97, Figure 8).


Wall motion in the stenotic carotid artery: association with greyscale plaque characteristics, the degree of stenosis and cerebrovascular symptoms.

Kanber B, Hartshorne TC, Horsfield MA, Naylor AR, Robinson TG, Ramnarine KV - Cardiovasc Ultrasound (2013)

Scatter plot showing a strong linear relationship between arterial diameters measured manually (Dmanual) and using our method (Dauto).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3818684&req=5

Figure 8: Scatter plot showing a strong linear relationship between arterial diameters measured manually (Dmanual) and using our method (Dauto).
Mentions: Our assessment of reproducibility showed mean intra-observer coefficients of variation of 1.0%, 1.2%, 11.7%, and 12.4% for the measurement of the systolic diameters, diastolic diameters, absolute systolic diameter changes, and percentage diameter changes, respectively. Comparison against manual measurements showed a mean difference in diameter measurements between the two techniques of −0.016 mm (Figure 7) which did not differ significantly from zero (p = 0.06, t-test). The 95% limits of agreement were −0.29 mm to 0.26 mm. Linear regression analysis showed a strong correlation between the measurements made using the two methods (R2 = 0.97, Figure 8).

Bottom Line: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment.The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%).Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Physics, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW UK. kumar.ramnarine@uhl-tr.nhs.uk.

ABSTRACT

Background: Systolic dilation of the atherosclerotic carotid artery depends on several factors including arterial compliance and the haemodynamic environment. The purpose of this study was to quantify wall motion in stenotic carotid arteries and investigate any associations with the ultrasound greyscale plaque characteristics, the degree of stenosis, and the presence of cerebrovascular symptoms.

Methods: Variations in the lumen diameters of 61 stenotic carotid arteries (stenosis range 10%-95%) from 47 patients were measured before the proximal shoulder of the atherosclerotic plaque using ultrasound image sequences over several cardiac cycles. Absolute and percentage diameter changes from diastole to systole were calculated and their relationship to the degree of stenosis, greyscale plaque characteristics, and the presence of ipsilateral hemispheric symptoms were studied.

Results: The mean absolute diameter change from diastole to systole was 0.45 mm (s.d. 0.17), and the mean percentage diameter change was 6.9% (s.d. 3.1%). Absolute and percentage diameter changes did not have a statistically significant relationship to the degree of stenosis, greyscale plaque characteristics, or the presence of ipsilateral hemispheric symptoms (p > 0.05). Parameters significantly correlated with the presence of symptoms were the degree of stenosis (p = 0.01), plaque greyscale median (p = 0.02) and the plaque surface irregularity index (p = 0.02).

Conclusions: Our study confirmed the degree of stenosis, plaque greyscale median and our surface irregularity index were significant predictors of symptoms, but found no significant correlation between diameter changes of stenosed carotid arteries and the presence of ipsilateral hemispheric symptoms.

Show MeSH
Related in: MedlinePlus