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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Sequentially based analysis versus image based analysis of Intima Media Thickness in common carotid arteries studies
M Sandrock1, J Hansel, J Schulze
1Medical Clinic, Department of Sports Medicine, University of Tuebingen, D-72074 Tuebingen, Germany. markus.sandrock@gmx.de
Insights
Sequential analysis (SBA) of intima-media thickness (IMT) provides more accurate cardiovascular risk assessment than image-based analysis (IBA). SBA better correlates with cardiovascular risk factors, suggesting IBA may underestimate risks for stroke and heart disease.
Area of Science:
- Cardiovascular research
- Medical imaging analysis
- Vascular diagnostics
Background:
- B-mode ultrasound is a non-invasive tool for assessing cardiovascular and cerebrovascular risk factors.
- Current image-based analysis (IBA) of intima-media thickness (IMT) may not adequately address variations in end-diastolic wall processes.
- This can lead to underestimation of the relationship between IMT and cardiovascular events.
Purpose of the Study:
- To compare the accuracy of sequentially based analysis (SBA) versus image-based analysis (IBA) for IMT measurement.
- To demonstrate variations in IBA and its potential to underestimate cardiovascular and stroke risk.
- To evaluate the correlation of both analysis methods with cardiovascular risk factors.
Main Methods:
- Analysis of 750,000 ultrasound images from 2500 healthy males aged 35-55.
- Comparison of IMT measurements using sequentially based analysis (SBA) and image-based analysis (IBA).
- Correlation analysis between IBA and SBA with cardiovascular risk factors, including Framingham CHD risk level (FCRL).
Main Results:
- SBA yielded significantly higher mean, maximal, and minimal IMT values in the common carotid artery (CCA) compared to IBA.
- SBA demonstrated a stronger correlation with all assessed cardiovascular risk factors.
- SBA showed a Pearson correlation of 0.81 (p < 0.01) with FCRL, while IBA showed 0.49 (p = 0.01).
Conclusions:
- Image-based analysis (IBA) fails to capture the true maximal IMT values.
- IBA may underestimate the association between IMT and cardiovascular risk factors.
- Sequential analysis (SBA) offers a more reliable method for IMT assessment and cardiovascular risk stratification.
Background:
Image-based B-mode ultrasound has gained popularity in major studies as a non-invasive method of measuring cardio- and cerebrovascular risk factors. However, none of the major studies appears to have paid sufficient attention to the variation in end diastolic wall process. By using sequentially based analyses (SBA) of Intima-Media Thickness (IMT), the general purpose of this study was to show that the current image based (ECG tracked) analysis (IBA) has some major variations and might underestimate the true relations for cardiovascular events and stroke for IMT measurement.
Method:
The study group consisted of 2500 healthy male subjects aged between 35 to 55 years. 4 sequences (300 images) were analyzed per subject. 750,000 images were analysed throughout the course of this study.
Results:
IBA showed significantly lower mean, maximal, and minimal values for IMT in CCA than for SBA. The correlation analysis between IBA and SBA with the cardio- and cerebrovascular risk factors showed a higher correlation of SBA for all risk factors. The Pearson coefficient was 0.81, p < 0.01, for SBA versus Framingham CHD risk level (FCRL) and 0.49, p = 0.01, for IBA versus FCRL.
Conclusion:
IBA did not measure the true maximal values of the IMT in this study. Together with the correlation analysis, this indicates that IBA might underestimate the true relations for IMT and risk factors.
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