Department of Radiology, Sainte Justine Hospital, University of Montreal, 3175 Cote-Sainte-Catherine Road, Montreal, Quebec, H3T 1C5, Canada.
Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
Eur Radiol. 2019 Jul;29(7):3854-3861. doi: 10.1007/s00330-019-06051-9. Epub 2019 Mar 7.
Evaluate non-invasive vascular elastography (NIVE) in detecting vascular changes associated with obese children.
Case-control study to evaluate NIVE in 120 children, 60 with elevated body mass index (BMI) (≥ 85th percentile for age and sex). Participants were randomly selected from a longitudinal cohort, evaluating consequences of obesity in healthy children with one obese parent. Radiofrequency ultrasound videos of the common carotid artery were obtained. The carotid wall was segmented and NIVE applied to measure cumulated axial strain (CAS), cumulated axial translation (CAT), cumulated lateral translation (CLT), maximal shear strain (Max |SSE|), and intima-media thickness (IMT). Multivariate analyses were used controlling for age, sex, Tanner stage, blood pressure, and low-density lipoprotein. Statistical significance was set to 0.05-0.008. Participants were 10-13 years old (mean 11.4 and 12.0, for normal and elevated BMI groups, p < 0.001), 58% and 63% boys, respectively. Groups differed in age, Tanner stage, and blood pressure. In the normal BMI group, there was weak correlation between systolic blood pressure and Max |SSE| (r = 0.316, p = 0.01) and weak correlation between pulse pressure and Max |SSE| (r = 0.259, p = 0.045). After Bonferroni correction, CAT was significantly higher in the elevated BMI group (0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm), p < 0.001. CAS/CAT was significantly lower in the elevated BMI group (9.54 ± 4.8 vs. 13.34 ± 6.46), p = 0.001. IMT was significantly higher in the elevated BMI group (0.36 ± 0.05 mm vs. 0.32 ± 0.05 mm) before Bonferroni correction, p = 0.013.
NIVE detected differences in CAT and CAS/CAT in elevated BMI children. NIVE is a promising technique to monitor radiological markers of subclinical atherosclerosis.
• NIVE is a non-invasive technique based on measurement of subsegmental focal deformation of vascular wall to detect subclinical changes in arterial wall compliance. • Children with elevated BMI showed increased carotid artery wall movement during systole, as compared to normal BMI children (mean 0.68 ± 0.24 mm vs. 0.52 ± 0.18 mm; p < 0.001) and a lower ratio of vascular wall strain to wall movement during systole (mean 9.54 ± 4.8 vs. 13.34 ± 6.46; p = 0.001). • The detection of these subclinical changes helps physicians in the stratification of children at risk of atherosclerosis and guides in the implementation of preventive measures.
评估非侵入性血管弹性成像（NIVE）在检测与肥胖儿童相关的血管变化中的作用。
这是一项病例对照研究，共纳入 120 名儿童，其中 60 名儿童的体质量指数（BMI）升高（≥同年龄和性别的第 85 百分位）。参与者是从一个纵向队列中随机选择的，该队列评估了肥胖父母中健康儿童肥胖的后果。使用射频超声视频获取颈总动脉。对颈动脉壁进行分割，并应用 NIVE 测量累积轴向应变（CAS）、累积轴向平移（CAT）、累积侧向平移（CLT）、最大剪切应变（Max |SSE|）和内膜中层厚度（IMT）。多变量分析控制了年龄、性别、Tanner 分期、血压和低密度脂蛋白。统计显著性设定为 0.05-0.008。参与者年龄为 10-13 岁（平均值分别为 11.4 和 12.0，正常 BMI 组和升高 BMI 组，p < 0.001），分别为 58%和 63%的男孩。两组在年龄、Tanner 分期和血压方面存在差异。在正常 BMI 组中，收缩压与 Max |SSE|之间存在弱相关性（r = 0.316，p = 0.01），脉压与 Max |SSE|之间存在弱相关性（r = 0.259，p = 0.045）。经过 Bonferroni 校正后，升高 BMI 组的 CAT 显著升高（0.68 ± 0.24mm 与 0.52 ± 0.18mm，p < 0.001）。升高 BMI 组的 CAS/CAT 显著降低（9.54 ± 4.8 与 13.34 ± 6.46，p = 0.001）。IMT 在 Bonferroni 校正前在升高 BMI 组中显著升高（0.36 ± 0.05mm 与 0.32 ± 0.05mm，p = 0.013）。
NIVE 检测到升高 BMI 儿童的 CAT 和 CAS/CAT 存在差异。NIVE 是一种有前途的技术，可以监测亚临床动脉粥样硬化的放射学标志物。
NIVE 是一种基于测量血管壁亚节段焦点变形的非侵入性技术，用于检测动脉壁顺应性的亚临床变化。
与正常 BMI 儿童相比，BMI 升高的儿童在收缩期表现出颈动脉壁运动增加（平均 0.68 ± 0.24mm 与 0.52 ± 0.18mm；p < 0.001），且血管壁应变与壁运动的比值降低（平均 9.54 ± 4.8 与 13.34 ± 6.46；p = 0.001）。
检测这些亚临床变化有助于医生对动脉粥样硬化风险儿童进行分层，并指导预防措施的实施。
