Carotid artery intima-media thickness measurement in children with normal and increased body mass index: a comparison of three techniques

Abstract

BackgroundCommon carotid artery intima-media thickness is a marker of subclinical atherosclerosis. In children, increased intima-media thickness is associated with obesity and the risk of cardiovascular events in adulthood.ObjectiveTo compare intima-media thickness measurements using B-mode ultrasound, radiofrequency (RF) echo tracking, and RF speckle probability distribution in children with normal and increased body mass index (BMI).Materials and methodsWe prospectively measured intima-media thickness in 120 children randomly selected from two groups of a longitudinal cohort: normal BMI and increased BMI, defined by BMI ≥85th percentile for age and gender. We followed Mannheim recommendations. We used M’Ath-Std for automated B-mode imaging, M-line processing of RF signal amplitude for RF echo tracking, and RF signal segmentation and averaging using probability distributions defining image speckle. Statistical analysis included Wilcoxon and Mann-Whitney tests, and Pearson correlation coefficient and intra-class correlation coefficient (ICC).ResultsChildren were 10–13 years old (mean: 11.7 years); 61% were boys. The mean age was 11.4 years (range: 10.0–13.1 years) for the normal BMI group and 12.0 years (range: 10.1–13.5 years) for the increased BMI group. The normal BMI group included 58% boys and the increased BMI group 63% boys. RF echo tracking method was successful in 79 children as opposed to 114 for the B-mode method and all 120 for the probability distribution method. Techniques were weakly correlated: ICC=0.34 (95% confidence interval [CI]: 0.27–0.39). Intima-media thickness was significantly higher in the increased BMI than normal BMI group using the RF techniques and borderline for the B-mode technique. Mean differences between weight groups were: B-mode, 0.02 mm (95% CI: 0.00 to 0.04), P=0.05; RF echo tracking, 0.03 mm (95% CI: 0.01 to 0.05), P=0.01; and RF speckle probability distribution, 0.03 mm (95% CI: 0.01 to 0.05), P=0.002.ConclusionThough techniques are not interchangeable, all showed increased intima-media thickness in children with increased BMI. RF echo tracking method had the lowest success rate at calculating intima-media thickness. For patient follow-up and cohort comparisons, the same technique should be used throughout.

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“…B-Mode imaging or radiofrequency multiple M-line analysis, influence the magnitude of IMT and, therefore, limit the comparability of the included studies. Thus, only one technique should be performed in prospective studies (67). Following Skilton et al (68), the choice of location of IMT measurement-at the carotid artery or the aorta-should be decided depending on the target group and the individual goal of each study.…”

Novel Simulation Model That Realizes Arterial and Venous Blood Flow for Ultrasound-Guided Central Venous Catheter Insertion in Children

“…For example, in patients aged 1 month to 2 years, the median internal diameters of the IJV and ICA are reportedly 8.9 mm and 4.3 mm, respectively [15] . In addition, the reported mean intima-media thickness of the ICA in children measured by B-mode US is 0.56 mm [16] .…”

Filtering and Detection of Intima-media Thickness (IMT) for the risk of Carotid Artery Atherosclerosis

“…Various techniques were used to detect the edge like thresholding technique [2], marker controlled watershed [9], gradient based [10], active contour [11], first order absolute moment edge operator [12]. Jalbout et al [13] has found that main reason behind atherosclerosis disease in childhood is obesity. The author has given the comparison of three RF techniques to measure the IMT of carotid artery.…”