An in vitro evaluation of the line pattern of the near and far walls of carotid arteries using B-mode ultrasound

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This in vitro study was executed to evaluate the double line pattern generated at both near and far walls of human carotid arteries using B-mode ultrasound. Therefore, extravascular (7.5 MHz) and intravascular (30 MHz) ultrasound imaging were performed at the same locations of the carotid artery. The thickness of the double line pattern of the extravascular image (7.5 MHz) was compared to the thickness of the intima-media complex seen on the corresponding intravascular image (30 MHz) and on the histologic section. At the far wall of the extravascular image, the measurements were executed at the leading edge of the echo. The data showed high correlation and agreement with the intravascular ( r = 0.91, p < 0.001; mean diff = −0.01 and SD diff = 0.12) and the histologic measurements ( r = 0.87, p < 0.001; mean diff = −0.12 and SD diff = 0.13). In addition, the results of the measurements of the intravascular image showed high correlations and agreement with the histologic data ( r near = 0.86, p < 0.001; mean diff = −0.08 and SD diff = 0.15, respectively, r far = 0.92, p < 0.001; mean diff = −0.12 and SD diff = 0.12). For comparison with other studies, near wall measurements were also included. These had to be performed at the trailing edge of the echoes to be compatible with these studies. The results of the measurements of the extravascular image showed poor correlations and lack of agreement with those of the intravascular ( r = 0.49, p = 0.03; mean diff = 0.09 and SD diff = 0.25) and of the histologic ( r = 0.37, p = 0.03; mean diff = 0.04 and SD diff = 0.23) measurements. These results can easily be explained from the physical limitations of measuring at the trailing edges. We conclude that the double line pattern seen at the far wall of the extravascular image is representative of the intima-media complex.