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High-resolution B-mode ultrasound reading methods in the Atherosclerosis Risk in Communities (ARIC) cohort. The ARIC
Insights
Standardized ultrasound protocols ensure reliable measurements of carotid artery dimensions, crucial for assessing cardiovascular disease risk factors in the general population. This improves the accuracy of intima-media thickness and artery diameter assessments.
Area of Science:
- Vascular Ultrasound
- Cardiovascular Epidemiology
- Medical Imaging Analysis
Background:
- Cardiovascular disease risk factors are associated with carotid artery changes.
- Accurate measurement of carotid artery dimensions is essential for risk assessment.
Purpose of the Study:
- To assess the association between cardiovascular disease risk factors and carotid artery dimensions.
- To evaluate the reproducibility of ultrasound measurements of carotid artery diameter and intima-media thickness.
Main Methods:
- Standardized ultrasound scanning and reading protocols were applied to 15,800 participants in the Atherosclerosis Risk in Communities (ARIC) Study.
- A subset of 855 participants underwent detailed measurements of carotid artery dimensions (diameter, intima-media thickness) by multiple readers.
- Between-reader reliability and coefficients of variation were calculated to assess measurement reproducibility.
Main Results:
- Between-reader reliability coefficients for wall thickness measurements ranged from 0.78 to 0.93.
- Coefficients of variation for wall thickness measurements ranged from 13.1% to 18.3%.
- High agreement (58-42%) was observed for far-wall thickness measurements within one image pixel across different readers.
Conclusions:
- Standardized ultrasound protocols and training lead to highly reproducible measurements of carotid artery dimensions.
- These reproducible measurements are vital for accurately assessing cardiovascular disease risk factors in population studies.
Abstract:
To measure the association of cardiovascular disease risk factors with carotid artery diameter and thickness of the intima and media in the general population, standardized ultrasound scanning and reading protocols were performed on 15,800 individuals in the multicenter Atherosclerosis Risk in Communities (ARIC) Study. In a randomly selected subset of 855 participants, the mean artery diameter, minimum lumen diameter, and maximum near- and far-wall thicknesses were measured at a core laboratory from B-mode image recordings of the common carotid, bifurcation, and internal carotid arteries to determine both within-reader and between-reader variability. Measurements associated with the wall thickness are sensitive indicators of reader reproducibility, with between-reader reliability coefficients ranging from 0.78 to 0.93 and coefficients of variation ranging from 13.1 to 18.3%. The percent of paired readings in the three carotid segments for which the absolute difference of the far-wall thickness measured by different readers was not greater than one image pixel (0.067 mm) was 58% (common carotid), 53% (internal carotid), and 42% (bifurcation). Highly reproducible measurements of carotid artery dimensions can be achieved with standardized training and performance of ultrasound scanning and reading protocols.