Three-dimensional ultrasound for carotid vessel wall volume measurement

Ying-An Chen; Pei-Ya Chen; Shinn-Kuang Lin

doi:10.4103/tcmj.tcmj_283_20

Three-dimensional ultrasound for carotid vessel wall volume measurement

Tzu Chi Med J. 2021 Apr 1;34(1):88-94. doi: 10.4103/tcmj.tcmj_283_20. eCollection 2022 Jan-Mar.

Authors

Ying-An Chen¹, Pei-Ya Chen^{1

2}, Shinn-Kuang Lin^{1

2}

Affiliations

¹ Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
² School of Medicine, Tzu Chi University, Hualien, Taiwan.

Abstract

Objectives: The intima-media thickness (IMT) of the carotid artery can now be detected on a three-dimensional (3D) plane. The 3D vessel wall volume (VWV) more accurately represents vascular conditions. Through 3D ultrasound, we established a standardized method for carotid VWV measurement.

Materials and methods: A total of thirty patients without stroke or cardiovascular disease who received carotid duplex sonography were retrospectively reviewed. Gray-scale 3D images from the distal common carotid artery (CCA) to internal carotid artery on both sides were acquired using a single-sweep 3D transducer and analyzed offline by using the vascular plaque quantification function of the Philips QLAB software. Then, the 3D IMT(QLAB intima-media thickness [QIMT]), total plaque volume (TPV), and VWV were measured by a neurologist and a technician, and the interobserver variability was assessed.

Results: The mean two-dimensional (2D) carotid IMT was 0.65 ± 0.12 mm. The mean QIMT, TPV, and VWV measured by observer 1 were 0.68 ± 0.18 mm, 26 ± 12 mm³, and 94 ± 10 mm³, respectively. The Bland-Altman plot of the mean differences between the QIMT, TPV, and VWV values measured by observers 1 and 2 showed that those of observer 2 were within two standard deviations of those of observer 1. Intraclass correlation coefficients (ICCs) indicated strong correlations in QIMT (ICC = 0.76), TPV (ICC = 0.85), and VWV (ICC = 0.90; P < 0.001) between observers 1 and 2. Both 2D IMT and 3D QIMT exhibited a positive linear correlation with age.

Conclusion: This study established a standardized VWV measurement through 3D ultrasound. Reasonable interobserver differences were obtained within a 95% limit of agreement and high reliability (ICC = 0.90). The VWV 1 cm from the CCA bifurcation was quantified with a mean value of 94.2 mm³. Further studies on the 3D ultrasound quantification of carotid arteries are warranted.

Keywords: Interobserver reliability; Intima–media thickness; Three-dimensional ultrasound; Total plaque volume; Vessel wall volume.