Pan Fu-Shun, Yu Liang, Luo Jia, Wu Ri-Dong, Xu Ming, Liang Jin-Yu, Zheng Yan-Ling, Xie Xiao-Yan
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, Guangzhou, China.
Department of Vascular and Thyroid Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Ultrasound Med. 2018 Dec;37(12):2759-2767. doi: 10.1002/jum.14630. Epub 2018 Apr 19.
To evaluate the feasibility of the ultrafast ultrasound pulsed wave velocity (PWV) for carotid stiffness assessment and potential influencing factors.
Ultrafast PWV measurements of 442 carotid arteries in 162 consecutive patients (patient group) and 66 healthy volunteers (control group) were performed. High- and very high-frequency transducers were used in 110 carotid segments. The ultrafast PWVs at the beginning and end of systole were automatically measured. The correlations between the intima-media thickness (IMT) and ultrafast PWV and the equipment and carotid factors influencing the utility of ultrafast PWV were analyzed.
Each ultrafast PWV acquisition was completed within 1 minute. The intraobserver variability showed mean differences ± SD of 0.12 ± 1.28 m/s for the PWV before systole and 0.06 ± 1.30 m/s for the PWV at the end of systole. Ultrafast PWV measurements were more likely obtained with the very high- frequency transducer when the IMT was less than 1.5 mm (P < .05). A generalized linear mixed-effects model analysis showed that the very high-frequency transducer had a greater ability to obtain a valid carotid ultrafast PWV measurement with an IMT of less than 1.5 mm (P < .05). The IMT was positively correlated with the PWV before systole and at the end of systole (r = 0.207-0.771; all P < .05) in the control group, patient group, and carotid subgroup with an IMT of less than 1.5 mm. A multiple regression analysis showed that the IMT and plaque were important independent factors in predicting failure of the ultrafast PWV (P < .001).
The ultrafast PWV is an effective and user-friendly method for evaluating carotid stiffness. The IMT and transducer type are factors influencing the ability to obtain an ultrafast PWV measurement.
评估超快速超声脉搏波速度（PWV）用于颈动脉僵硬度评估的可行性及潜在影响因素。
对162例连续患者（患者组）的442条颈动脉和66名健康志愿者（对照组）进行超快速PWV测量。110个颈动脉节段使用了高频和甚高频换能器。自动测量收缩期开始和结束时的超快速PWV。分析了内膜中层厚度（IMT）与超快速PWV之间的相关性以及影响超快速PWV实用性的设备和颈动脉因素。
每次超快速PWV采集均在1分钟内完成。观察者内变异性显示，收缩期前PWV的平均差异±标准差为0.12±1.28m/s，收缩期末PWV的平均差异±标准差为0.06±1.30m/s。当IMT小于1.5mm时，使用甚高频换能器更有可能获得超快速PWV测量值（P<.05）。广义线性混合效应模型分析显示，对于IMT小于1.5mm的情况，甚高频换能器获得有效颈动脉超快速PWV测量值的能力更强（P<.05）。在对照组、患者组以及IMT小于1.5mm的颈动脉亚组中，IMT与收缩期前和收缩期末的PWV呈正相关（r=0.207 - 0.771；所有P<.05）。多元回归分析显示，IMT和斑块是预测超快速PWV失败的重要独立因素（P<.001）。
超快速PWV是评估颈动脉僵硬度的一种有效且用户友好的方法。IMT和换能器类型是影响获得超快速PWV测量值能力的因素。
