Poredos Pavel
Department for Vascular Disease, University Medical Centre, Ljubljana, Slovenia.
Vasc Med. 2004 Feb;9(1):46-54. doi: 10.1191/1358863x04vm514ra.
The measurement of intima-media thickness (IMT) of large superficial arteries, especially the carotid, using high-resolution B-mode ultrasonography has emerged as one of the methods of choice for determining the anatomic extent of atherosclerosis and for assessing cardiovascular risk. IMT measurement obtained by ultrasonography correlates very well with pathohistologic measurements and the reproducibility of this technique is good. Population studies have shown a strong correlation between carotid IMT and several cardiovascular risk factors, and it has also been found to be associated with the extent of atherosclerosis and end-organ damage of high-risk patients. Therefore, increased carotid IMT is a measure of atherosclerotic burden and a predictor of subsequent events. Because of its quantitative value, carotid IMT measurement is more and more frequently used in clinical trials to test the effects of different preventive measures, including drugs. More recently, there has been interest in the clinical use of this technique for detecting preclinical (asymptomatic) atherosclerosis and for identifying subjects at high risk. Measurement of carotid IMT could influence a clinician to intervene with medication and to use more aggressive treatment of risk factors in primary prevention, and in patients with atherosclerotic disease in whom there is evidence of progression and extension of atherosclerotic disease. For more extensive use of this method in clinical practice a consensus concerning the standardization of methods of measurement and precise definition of threshold between normal and pathologic IMT value is urgently needed.
使用高分辨率B型超声测量大的浅表动脉，尤其是颈动脉的内膜中层厚度（IMT），已成为确定动脉粥样硬化解剖范围和评估心血管风险的首选方法之一。超声获得的IMT测量值与病理组织学测量结果相关性很好，并且该技术的可重复性良好。人群研究表明，颈动脉IMT与多种心血管危险因素之间存在很强的相关性，并且还发现它与高危患者的动脉粥样硬化程度和终末器官损害有关。因此，颈动脉IMT增加是动脉粥样硬化负担的一个指标，也是后续事件的一个预测因子。由于其定量价值，颈动脉IMT测量在临床试验中越来越频繁地用于测试不同预防措施（包括药物）的效果。最近，人们对该技术在检测临床前（无症状）动脉粥样硬化和识别高危受试者方面的临床应用产生了兴趣。颈动脉IMT测量可能会促使临床医生进行药物干预，并在一级预防中以及在有动脉粥样硬化疾病进展和扩展证据的患者中对危险因素采取更积极的治疗措施。为了在临床实践中更广泛地使用该方法，迫切需要就测量方法的标准化以及正常与病理IMT值之间阈值的精确定义达成共识。
