Noninvasive imaging protocols to detect and monitor carotid atherosclerosis progression

It has been shown that B-mode ultrasound imaging is a valid and reliable technique to measure arterial wall thickness. Based on the results of early validation studies and relatively small-scale investigations, large-scale epidemiologic studies using high-resolution ultrasonography were designed to provide information on the association of wall thickness and cardiovascular risk factors, and to determine the prevalence, extent, and severity of peripheral atherosclerosis. Recent reports indicate that ultrasonographic endpoints correlate with the most important cardiovascular risk factors. Furthermore, noninvasive carotid endpoints have been shown to be predictive of clinical atherosclerosis status with a high degree of confidence. B-mode ultrasonography has also been used to evaluate prospectively the natural history of peripheral atherosclerosis by monitoring lesion growth over time. Recently, ultrasonographic measurements of the arterial wall have been chosen as the primary and secondary endpoints for several clinical trials of the antiatherogenic effects of behavioral and pharmacologic interventions on major cardiovascular risk factors such as hypercholesterolemia and hypertension.