de Groot Eric, van Leuven Sander I, Duivenvoorden Raphaël, Meuwese Marijn C, Akdim Fatima, Bots Michiel L, Kastelein John Jp
Department of Vascular Medicine, Academic Medical Centre, Room F4-159-2, Meibergdreef 9, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
Nat Clin Pract Cardiovasc Med. 2008 May;5(5):280-8. doi: 10.1038/ncpcardio1163. Epub 2008 Mar 11.
Imaging modalities have been developed to assess atherosclerosis in vivo in the arterial wall because large clinical end-point studies are time-consuming and costly. Historically, in-hospital angiography and Doppler ultrasonography have been used to assess atherosclerosis development. Investigations of the arterial lumen are, however, increasingly being replaced by modalities that can measure changes in the arterial wall itself-intravascular ultrasonography, MRI and multislice CT. The fact that intravascular ultrasonography is invasive, CT involves substantial radiation exposure and requires contrast agents, and that MRI is time-consuming and technically challenging all limit the widespread use of these techniques. Moreover, all modalities have high associated costs. B-mode ultrasonographic imaging of the carotid arterial walls occupies a unique position in atherosclerosis research. This method enables sensitive, reproducible and noninvasive assessment of intima-media thickness (IMT) as a continuous variable. Epidemiological and clinical trial evidence as well as digitization and standardization have made carotid IMT a validated and accepted marker for generalized atherosclerosis burden and vascular disease risk. Here we describe the application of carotid IMT measurements as a tool in risk evaluation of individuals and in studies of atherosclerosis progression and regression.
由于大型临床终点研究耗时且成本高昂，因此已开发出多种成像方式用于在体内评估动脉壁中的动脉粥样硬化。历史上，医院内血管造影和多普勒超声检查一直用于评估动脉粥样硬化的发展。然而，对动脉管腔的研究正越来越多地被能够测量动脉壁本身变化的方式所取代，如血管内超声、磁共振成像（MRI）和多层螺旋CT。血管内超声具有侵入性、CT涉及大量辐射暴露且需要使用造影剂，以及MRI耗时且技术要求高，这些事实都限制了这些技术的广泛应用。此外，所有这些方式都有很高的相关成本。颈动脉壁的B型超声成像在动脉粥样硬化研究中占据独特地位。这种方法能够将内膜中层厚度（IMT）作为一个连续变量进行敏感、可重复且无创的评估。流行病学和临床试验证据以及数字化和标准化已使颈动脉IMT成为用于评估全身性动脉粥样硬化负担和血管疾病风险的经过验证且被认可的标志物。在此，我们描述了将颈动脉IMT测量作为一种工具在个体风险评估以及动脉粥样硬化进展和消退研究中的应用。
