Recent intravascular ultrasound experience challenges the accuracy of ultrasonic measurement of arterial wall thickness. We reevaluated the correlation between histological and sonographic measurements of intima-media thickness using standard transcutaneous vascular technology. Carotid and femoral arterial segments were imaged before and after fixation using a 7-MHz linear-array vascular transducer. Log compression and beam orientation were varied. Mean intima, media, and adventitia thicknesses were measured and compared with corresponding histological tunica. Tissue processing caused 2.5% shrinkage. Intraobserver reading error was 0.7% for histology and 5.4% for sonography. Ultrasound overestimated the thickness of the intima and adventitia and underestimated the thickness of the media. For combined intima-media thickness, the differences between histology and imaging were insignificant, averaging 4% for the carotid artery and 9% for the femoral artery in the far-wall projection. In the near-wall projection, sonographic intima-media thickness was 20% less than that determined histologically. We conclude that ultrasonography is limited mainly by axial resolution in quantifying the dimensions of individual arterial tunica but is capable of accurately measuring far-wall intima-media thickness. ( In the evolution of these applications, the technology has met rigorous standards of reproducibility for measuring carotid intima-media thickness.3 The validity and accuracy of the measurement are based on pathological and clinical correlations described by Pignoli et al 4 in 1986. However, recent data from intravascular ultrasound experience have challenged the accuracy of quantitative transcutaneous vascular sonography. 5 - 9Our purpose was to reevaluate in vitro measurements of arterial wall segment thicknesses obtained by histology and by current vascular sonography. We found systematic differences that are inherent with ultrasound technology but do not invalidate the quantification of intima-media thickness. Methods Segments from common carotid and femoral arteries were taken during the autopsies of 36 male subjects who died at an age of 69 ±8 (mean±l SD) years. After removing fat and loose tissue from the adventitia, the vessels were opened longitudinally. They were then clamped to frames for fixation in 10% formalin and for imaging before and after fixation. The specimens were divided longitudinally in the line of the imaging plane. A block of tissue measuring 20 x 2.5 x thickness of the wall (mm 3 ) was taken from the vertical center of either side of the imaging plane, corresponding with the center of the sonogram (Figure 1). The cut edges were photographed on 35-mm slide film to determine the amount of shrinkage incurred during histological processing. HistologyThe sections were marked with india ink for orientation and placed in perforated plastic cassettes for ethanol dehydration, xylene substitute clearing, and paraffin embedment. Four sections (5 ftm thick) were sectioned by rotary microtome from the imaging ...

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Two cases of ventricular septal aneurysm are reported, one in the membranous septum and one in the muscular portion. The diagnosis was made by selective left ventricular angiography. It is suggested that these cases represent spontaneous closure of a ventricular septal defect with weakness and aneurysmal [see table in the PDF file] formation due to the high left ventricular pressure. Both are asymptomatic and hemodynamically within normal limits. Surgical repair of the aneurysms is not considered necessary.