Nezu Tomohisa, Hosomi Naohisa, Aoki Shiro, Matsumoto Masayasu
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.
J Atheroscler Thromb. 2016;23(1):18-31. doi: 10.5551/jat.31989. Epub 2015 Oct 13.
The carotid intima-media thickness (IMT) is a widely used surrogate marker for atherosclerosis worldwide. The carotid IMT can be simply, noninvasively, and reproducibly measured through B-mode carotid ultrasound. The carotid IMT is also a strong predictor of future cerebral and cardiovascular events. In addition, regressions of increased carotid IMT by lipid-lowering and antihypertensive drugs have been reported. Despite the strong association between increased carotid IMT and cardiovascular disease, it remains unclear whether routine carotid IMT measurement is useful for the detection of subclinical atherosclerosis in clinical practice. Researches should consider other methodological aspects, such as the definition of carotid plaques, the choice of measurement sites on the common or internal carotid artery, and the assessment of maximum or minimum IMT. The detailed guidelines for measuring carotid IMT vary by county. Thus, the usefulness of the carotid IMT may be assessed in different countries taking racial differences into account. Other important parameters revealed by carotid ultrasound, such as artery stenosis and the characteristics and size of plaques, should also be considered. Physicians should comprehensively interpret the results of carotid ultrasonography. Therefore, carotid ultrasonography is an essential tool for assessing cardiovascular risk in clinical settings.
颈动脉内膜中层厚度(IMT)是全球广泛使用的动脉粥样硬化替代标志物。通过B型颈动脉超声可以简单、无创且可重复地测量颈动脉IMT。颈动脉IMT也是未来脑卒中和心血管事件的有力预测指标。此外,已有报道称降脂药和降压药可使颈动脉IMT增厚现象出现消退。尽管颈动脉IMT增加与心血管疾病之间存在密切关联,但在临床实践中,常规测量颈动脉IMT对检测亚临床动脉粥样硬化是否有用仍不明确。研究应考虑其他方法学方面,如颈动脉斑块的定义、颈总动脉或颈内动脉测量部位的选择以及最大或最小IMT的评估。测量颈动脉IMT的详细指南因国家而异。因此,在考虑种族差异的情况下,不同国家可能会对颈动脉IMT的有用性进行评估。还应考虑颈动脉超声显示的其他重要参数,如动脉狭窄以及斑块的特征和大小。医生应全面解读颈动脉超声检查结果。因此,颈动脉超声检查是临床评估心血管风险的重要工具。