Abstract
Carotid intima-media thickness (cIMT) is a surrogate marker of early atherosclerotic changes in children. cIMT-studies are hard to compare, due to variations in ultrasound protocols, especially regarding the common carotid artery (CCA) segment measured in relation to the bulb. This study’s purpose was therefore to compare two distinct CCA segments in children, to see if cIMT values differ substantially according to the site of measurement. cIMT was assessed after power calculation in 30 children (15 girls) aged 8–17, using B-Mode ultrasound (5–13 MHz) at two CCA locations. The first measurement was performed over a distance of 1 cm immediately after the bulb (A), the second 1cm proximal the bulb (B) over the same distance of 1cm length. Means of end-diastolic far wall cIMT were compared between measurement A and B. cIMT in 30 participants was 0.51±0.06 mm for measurement A and 0.51±0.05 mm for measurement B. Results did not differ significantly (p = .947) over a distance of 2 cm after the bulb. According to our results, studies measuring CCA IMT within the first 2 cm, either close to the bulb or further proximal, can be compared. This will improve interpretation of data and application of reference values.
Highlights
Carotid intima-media thickness is applied as prognostic subclinical marker of atherosclerosis in healthy children and adolescents [1,2,3,4] as well as in children in chronic conditions [5,6,7,8,9]
CIMT study results are hard to compare due to variations in ultrasound measurement protocols. Carotid intima-media thickness (cIMT) measurements can be made at the common carotid artery (CCA), bifurcation (BIF) or internal carotid artery (ICA)–but even if the same arterial segment is referred to, these segments are not identical
This study investigated if there is a difference in IMT measured at two CCA segments, first, over a distance of 1cm length immediately proximal to the bulb, and second, over a distance of 1cm length proximal to the first segment
Summary
Carotid intima-media thickness (cIMT) is applied as prognostic subclinical marker of atherosclerosis in healthy children and adolescents [1,2,3,4] as well as in children in chronic conditions [5,6,7,8,9]. CIMT study results are hard to compare due to variations in ultrasound measurement protocols. CIMT measurements can be made at the common carotid artery (CCA), bifurcation (BIF) or internal carotid artery (ICA)–but even if the same arterial segment is referred to, these segments are not identical. Out of 26 studies there is none that applied a uniform scanning protocol (Table 1). CIMT was measured either 1-2cm proximal the bifurcation [1, 4, 5, 17], which is slightly different to others, who indicate the same distance (1–2 cm) but proximal to the bulb [6, 11, 12] and to those, measuring only 1 cm proximal to the bifurcation [8, 16, 20, 21] or 1 cm proximal to the bulb [14, 23, 24, 26]. No cIMT Difference between Two CCA Segments in Children Meyer et al [19] and Woo et al [9] define their location
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