Gállego Pérez-Larraya Jaime, Irimia Pablo, Martínez-Vila Eduardo, Barba Joaquín, Guembe María Jesús, Varo Nerea, Castellano José María, Viñes José Javier, Díez Javier
Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, Pamplona, Spain.
J Clin Ultrasound. 2012 Oct;40(8):479-85. doi: 10.1002/jcu.21916. Epub 2012 Apr 17.
The assessment of carotid intima-media thickness (CIMT) may improve cardiovascular risk prediction. The optimal protocol for CIMT measurement is unclear. CIMT may be measured in the common carotid artery (CCA), carotid bifurcation (CB), and internal carotid artery (ICA), but measurements from CB and ICA are more difficult to obtain. We studied the influence of body mass index (BMI) and atheroma plaques on the capacity to obtain CIMT measurements at different carotid sites.
Using an automatic system, CIMT was measured in 700 subjects aged 45-75, in the near and far walls of CCA, CB, and ICA bilaterally. The presence of atheroma plaques, BMI and vascular risk factors were recorded.
CIMT measurements in CCA were possible in all except one subject. It was not possible to obtain CIMT measurements at CB or ICA in 24.1% of normal weight and 58.8% of obese subjects. The likelihood of obtaining CIMT measurement at all carotid sites decreased as the BMI increased. Atheroma plaques in a carotid segment did not preclude CIMT measurement at this site.
CIMT measurements in distal carotid segments are more challenging in obese subjects. Measuring CIMT at CCA remains feasible in obese subjects and should be the primary endpoint in these subjects. Nevertheless, CB and ICA measurements, when feasible, would improve risk classification.
颈动脉内膜中层厚度（CIMT）的评估可能会改善心血管风险预测。CIMT测量的最佳方案尚不清楚。CIMT可在颈总动脉（CCA）、颈动脉分叉处（CB）和颈内动脉（ICA）进行测量，但从CB和ICA获取测量值更困难。我们研究了体重指数（BMI）和动脉粥样斑块对在不同颈动脉部位获取CIMT测量值能力的影响。
使用自动系统，对700名年龄在45 - 75岁的受试者双侧CCA、CB和ICA的近壁和远壁进行CIMT测量。记录动脉粥样斑块的存在情况、BMI和血管危险因素。
除一名受试者外，所有受试者的CCA均可进行CIMT测量。在正常体重受试者中，24.1%无法在CB或ICA获得CIMT测量值，在肥胖受试者中这一比例为58.8%。随着BMI增加，在所有颈动脉部位获得CIMT测量值的可能性降低。颈动脉段的动脉粥样斑块并不妨碍在该部位进行CIMT测量。
肥胖受试者中，颈动脉远端节段的CIMT测量更具挑战性。在肥胖受试者中，在CCA测量CIMT仍然可行，且应作为这些受试者的主要测量点。然而，当可行时，CB和ICA的测量将改善风险分类。
