Reply from the authors of the article entitled “Importance of accurate measurement of carotid intima media thickness for evaluating epileptic children treated with valproate”

Abstract

Dear Editor: We read with great interest the letter by Ozkan et al. As everyone knows, common carotid artery intima–media thickness (CAIMT) measurements vary during cardiac cycles in children. It is thicker during the QRS complex on electrocardiography (ECG). Carotid ultrasound should be performed with an ECG, and CAIMT should be measured at the same point on the ECG to overcome this variation [1]. Furthermore, we obtained a simultaneous ECG tracing for the purposes of gating and measured CAIMT at the R wave on ECG. But, unfortunately, our machine is Philips Sonos 5500 system. “Meticulous attention to quality control in image acquisition, measurement, interpretation, and reporting are essential for implementation of this technique especially in pediatric clinical practice.” This rule is absolutely right, but, as is known, machines nowadays have a very good resolution and these measurements should be repeated with new technology by experienced ultrasonographers.