Wendelhag I, Wiklund O, Wikstrand J
Wallenberg Laboratory for Cardiovascular Research, Sahigrenska Hospital, Göteborg University, Sweden.
Arterioscler Thromb Vasc Biol. 1996 Jul;16(7):843-50. doi: 10.1161/01.atv.16.7.843.
The aim of the present analysis in an ongoing observational study was to evaluate the possibility of measuring plaque size in ultrasound images from carotid and femoral arteries and the usefulness of quantitative plaque measurements in such a prospective study. Twenty-five patients with carotid plaques were identified in a group of patients with familial hypercholesterolemia (n = 50) compared with 7 subjects in a low-risk control group (n = 47). Only 20 of the 32 recorded plaques were accessible for quantitative follow-up measurements of area, base length, and thickness, which represents only 21% of all subjects investigated. In contrast, paired observations of intima-media thickness in the common carotid artery were available in 98% and in the carotid bulb in 87% of the subjects investigated. In those with paired observations of plaque area available, the data indicated a close relationship between the 2-year change recorded in plaque area and the 2-year change in intima-media thickness measured in a 10-mm-long predefined section of the carotid bulb (r = .81, P < .001, n = 19). The corresponding relationship between change in plaque area and change in a 10-mm-long section of the common carotid artery was r = .38 and P < .05 (n = 20). Quantitative measurements of plaques in the femoral arteries were also performed, but the results from these measurements were in most cases judged not to be useful. However, measurements of intima-media thickness in a 15-mm-long predefined section of the common femoral artery may be performed in a reproducible way in most patients. We conclude that the usefulness of plaque area measurements in prospective studies of the carotid artery seems limited because plaques available for quantitative measurements are present in only a small proportion of subjects. However, reproducible measurements of intima-media thickness in a predefined section of the carotid bulb are achievable in most subjects, and our data indicate that the changes recorded over time in the carotid bulb closely mirror changes occurring in the size of atherosclerotic plaques within the carotid artery region. In addition, present data indicate that measurements of intima-media thickness in the common carotid artery complement measurements performed in the carotid artery bulb in the study of early atherosclerosis.
在一项正在进行的观察性研究中，本次分析的目的是评估在颈动脉和股动脉的超声图像中测量斑块大小的可能性，以及在这样一项前瞻性研究中进行定量斑块测量的实用性。在一组家族性高胆固醇血症患者（n = 50）中，识别出25例有颈动脉斑块的患者，与之相比，低风险对照组（n = 47）中有7例。在记录的32个斑块中，只有20个可用于面积、基底长度和厚度的定量随访测量，这仅占所有研究对象的21%。相比之下，在98%的研究对象中可获得颈总动脉内膜中层厚度的配对观察数据，在87%的研究对象中可获得颈动脉窦内膜中层厚度的配对观察数据。在那些有斑块面积配对观察数据的患者中，数据表明斑块面积记录的2年变化与在颈动脉窦10毫米长的预定义节段中测量的内膜中层厚度的2年变化之间存在密切关系（r = 0.81，P < 0.001，n = 19）。斑块面积变化与颈总动脉10毫米长节段变化之间的相应关系为r = 0.38，P < 0.05（n = 20）。也对股动脉斑块进行了定量测量，但在大多数情况下，这些测量结果被判定为无用。然而，在大多数患者中，可以以可重复的方式在股总动脉15毫米长的预定义节段中测量内膜中层厚度。我们得出结论，在颈动脉前瞻性研究中，斑块面积测量的实用性似乎有限，因为只有一小部分研究对象存在可用于定量测量的斑块。然而，在大多数研究对象中，可以在颈动脉窦的预定义节段中实现可重复的内膜中层厚度测量，并且我们的数据表明，随着时间推移在颈动脉窦中记录的变化密切反映了颈动脉区域内动脉粥样硬化斑块大小的变化。此外，目前的数据表明，在早期动脉粥样硬化研究中，颈总动脉内膜中层厚度的测量补充了在颈动脉窦中进行的测量。
