Ultrasound Images Of Carotid Artery Research Articles

Ultrasound shear wave elastography imaging of common carotid arteries in patients with Spontaneous Coronary Artery Dissection (SCAD)

BackgroundShear wave elastography (SWE) is emerging as a valuable clinical tool for a variety of conditions. The aim of this pilot study was to assess the potential of SWE imaging of the common carotid arteries (CCA) in patients with spontaneous coronary artery dissection (SCAD), a rare but potentially life-threatening condition, hypothesized to be linked to changes in vessel wall elasticity.MethodsUltrasound shear wave elastography (SWE) estimates of artery wall elasticity were obtained from the left and right CCAs of 89 confirmed SCAD patients and 38 non-dissection controls. SWE images obtained over multiple cardiac cycles were analysed by a blinded observer to estimate elasticity in the form of a Young’s Modulus (YM) value, across regions of interest (ROI) located within the anterior and posterior CCA walls.ResultsYM estimates ranged from 17 to 133 kPa in SCAD patients compared to 34 to 87 kPa in non-dissection controls. The mean YM of 55 [standard deviation (SD): 21] kPa in SCAD patients was not significantly different to the mean of 57 [SD: 12] kPa in controls, p = 0.32. The difference between groups was 2 kPa [95% Confidence Interval − 11, 4].ConclusionsSWE imaging of CCAs in SCAD patients is feasible although the clinical benefit is limited by relatively high variability of YM values which may have contributed to our finding of no significant difference between SCAD patients and non-dissection controls.

Adaptation of Cardinal Points Symmetry Landmarks Distribution Model to in-vivo B-Mode Ultrasound Images of Transverse Cross-section of Carotid Arteries

The geometry of the imaged transverse cross-section of carotid arteries in in-vivo B-mode ultrasound images are most times irregular, unsymmetrical, full of speckles and usually non-uniform. We had earlier developed a technique of cardinal point symmetry landmark distribution model (CPS-LDM) to completely characterize the Region of Interest (ROI) of the geometric shape of thick-walled simulated B-mode ultrasound images of carotid artery imaged in the transverse plane, but this was based on the symmetric property of the image. In this paper, this developed technique was applied to completely characterize the region of interest of the geometric shape of in-vivo B-mode ultrasound images of non-uniform carotid artery imaged in the transverse plane. In order to adapt the CPS-LD Model to the in-vivo carotid artery images, the single VS-VS vertical symmetry line common to the four ROIs of the symmetric image is replaced with each ROI having its own VS-VS vertical symmetry line. This adjustment enables the in-vivo carotid artery images possess symmetric properties, hence, ensuring that all mathematical operations of the CPS-LD Model are conveniently applied to them. This adaptability was observed to work well in segmenting the in-vivo carotid artery images. This paper shows the adaptive ability of the developed CPS-LD Model to successfully annotate and segment in-vivo B-mode ultrasound images of carotid arteries in the transverse cross-sectional plane either they are symmetrical or unsymmetrical.

Adaptation of Cardinal Points Symmetry Landmarks Distribution Model to in-vivo B-Mode Ultrasound Images of Transverse Cross-section of Carotid Arteries

The geometry of the imaged transverse cross-section of carotid arteries in in-vivo B-mode ultrasound images are most times irregular, unsymmetrical, full of speckles and usually non-uniform. We had earlier developed a technique of cardinal point symmetry landmark distribution model (CPS-LDM) to completely characterize the Region of Interest (ROI) of the geometric shape of thick-walled simulated B-mode ultrasound images of carotid artery imaged in the transverse plane, but this was based on the symmetric property of the image. In this paper, this developed technique was applied to completely characterize the region of interest of the geometric shape of in-vivo B-mode ultrasound images of non-uniform carotid artery imaged in the transverse plane. In order to adapt the CPS-LD Model to the in-vivo carotid artery images, the single VS-VS vertical symmetry line common to the four ROIs of the symmetric image is replaced with each ROI having its own VS-VS vertical symmetry line. This adjustment enables the in-vivo carotid artery images possess symmetric properties, hence, ensuring that all mathematical operations of the CPS-LD Model are conveniently applied to them. This adaptability was observed to work well in segmenting the in-vivo carotid artery images. This paper shows the adaptive ability of the developed CPS-LD Model to successfully annotate and segment in-vivo B-mode ultrasound images of carotid arteries in the transverse cross-sectional plane either they are symmetrical or unsymmetrical.

Effect of despeckling filters on the segmentation of ultrasound common carotid artery images

BackgroundCarotid intima-media thickness (IMT) measured in B-mode ultrasound image is an important indicator of Atherosclerosis disease. Speckle noise inherently present in ultrasounds’ thereby degrades the visual evaluation and limits the automated segmentation performance. The objective of this study is to investigate the effects of three despeckle filters on the segmentation of carotid IMT in ultrasound image. MethodsAutomated segmentation of IMT is achieved by utilizing fast fuzzy c-mean clustering and distance-regularized level set without re-initialization techniques. Manual segmentation has been done by an experienced radiologist. The performances of median, hybrid median and improved adaptive complex diffusion (IACDF) filters are examined and a quantitative and qualitative comparison among these filters has been reported on 151 DICOM images. Bland–Altman plots were used to compare IMT results of these filters.Furthermore, performances of above three filters are evaluated under different noise levels by individually adding speckle and salt and pepper noise in ten randomly selected images from 151 DICOM dataset. Plots between noise and quality evaluation metric parameters are used to compare de-noising performance of these filters. ResultsThe average processing time per image of proposed IMT measurement technique without-filter and with filter is approx 15.39 s max. ConclusionIt is shown that the median filter (window 5 × 5) measures better than hybrid median and IACDF filters. Finally, concluded that de-noising of ultrasound image before segmentation procedure certainly improves segmentation accuracy. Furthermore, it is observed that these filters do not impose serious computational burden and entail moderate processing time.

The Effects of Moderate‐to‐Vigorous Physical Activity on Arterial Stiffness during Pregnancy

Moderate-to-vigorous physical activity (MVPA) is associated with lower arterial stiffness in the general population. The objective of the present study was to investigate the relationship between MVPA and arterial stiffness in pregnancy. Thirty-nine women participated in this study resulting in 68 measurements in non-pregnant (NP; n=21), first (TM1; n=8), second (TM2; n=20), and third trimesters (TM3; n=19). Carotid to femoral (central) and carotid to finger (peripheral) pulse wave velocity (PWV) were assessed using finometer (proper digital artery), tonometer (carotid artery), and ultrasound (femoral artery). Carotid artery distensibility, compliance, elasticity, and ß-stiffness were calculated from carotid artery diameters at diastole and systole from three ultrasound images of the right carotid artery assessed using manual digital calipers. MVPA was measured during the waking hours of 7-consecutive days using accelerometry (Actigraph; model wGT3X-BT). Freedson accelerometer counts for MVPA were ≥ 1,952 cmp. Comparisons between pregnant and non-pregnant participants and according to gestational age (in pregnant participants only) were performed using multilevel linear regression models adjusted for multiple tests per participant during the study period (NP, TM1, TM2, or TM3) using random effects for modelling intra-cluster correlation to generate β coefficients and 95% confidence intervals (CI). Carotid artery distensibility, elasticity, and β-stiffness were not statistically different between the NP, TM1, TM2, and TM3 phases. However, carotid compliance was higher in TM2 compared to NP. Central and peripheral PWV did not differ between pregnant and non-pregnant participants. Though, meeting the MVPA guidelines (≥150minutes per week) was associated with a decrease in both central PWV (Adj. β coef.: -0.30; 95% CI: -0.58, -0.02, p=0.04) and peripheral PWV (Adj. β coef.: -0.54; 95% CI: -0.91, -0.16, p=0.005) in pregnant and non-pregnant assessments. Central PWV (β Coef: -0.14, 95% CI: -0.27, -0.02, p=0.024; n=42), varied according to gestational age with a decrease in mid-pregnancy and subsequent increase to late pregnancy while gestational age was not significantly associated with peripheral PWV. Adjustment for meeting the MVPA guidelines (β Coef: -0.34, 95% CI: -0.62, -0.06, p=0.016) reduced the association between gestational age and central-PWV (Figure 1). These results suggest that there is a relationship between MVPA and arterial stiffness throughout pregnancy. This may explain a proportion of the correlation between increased physical activity and a reduced risk of hypertension-related disorders in pregnancy.

Childhood traffic-related air pollution and adverse changes in subclinical atherosclerosis measures from childhood to adulthood

BackgroundChronic exposure to air pollutants is associated with increased risk of cardiovascular disease (CVD) among adults. However, little is known about how air pollution may affect the development of subclinical atherosclerosis in younger populations. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis that provides insight into early CVD pathogenesis.MethodsIn a pilot study of 70 participants from the Southern California Children’s Health Study, we investigated CIMT progression from childhood to adulthood. Using carotid artery ultrasound images obtained at age 10 and follow-up images at age 21–22, we examined associations between childhood ambient and traffic-related air pollutants with changes in CIMT over time and attained adult CIMT using linear mixed-effects models adjusted for potential confounders.Average residential childhood exposures (i.e., birth to time of measurement at 10–11 years) were assigned for regional, ambient pollutants (ozone, nitrogen dioxide, particulate matter, interpolated from regulatory air monitoring data) and traffic-related nitrogen oxides (NOx) by road class (modeled using the CALINE4 line source dispersion model). Traffic density was calculated within a 300-m residential buffer.ResultsFor each 1 standard deviation (SD) increase in childhood traffic-related total NOx exposure, we observed greater yearly rate of change in CIMT from childhood to adulthood (β: 2.17 μm/yr, 95% CI: 0.78–3.56). Increases in annual rate of CIMT change from childhood to adulthood also were observed with freeway NOx exposure (β: 2.24 μm/yr, 95% CI: 0.84–3.63) and traffic density (β: 2.11 μm/yr, 95% CI: 0.79–3.43). Traffic exposures were also related to increases in attained CIMT in early adulthood. No associations of CIMT change or attained level were observed with ambient pollutants.ConclusionsOverall, we observed adverse changes in CIMT over time in relation to childhood traffic-related NOx exposure and traffic density in our study population. While these results must be cautiously interpreted given the limited sample size, the observed associations of traffic measures with CIMT suggest a need for future studies to more fully explore this relationship.

Fully Automated Integrated Segmentation of Carotid Artery Ultrasound Images Using DBSCAN and Affinity Propagation

PurposeB-mode ultrasound images are used in identifying the presence of fat deposit if any in carotid artery. The intima media, lumen, bifurcation boundary is detected by the echogenic characteristics embedded in the carotid artery.MethodsA fully automatic self-learning based segmentation is proposed by extracting the edges by a modified affinity propagation, which are given as inputs to the Density Based Spatial Clustering of Applications with Noise (DBSCAN) for super pixel segmentation. The segmented results are analyzed with Gradient Vector Flow (GVF) snake model and Particle Swarm Optimization (PSO) clustering based segmentation using various performance measures.ResultsThe proposed parameter free, fully automatic segmentation method combining Affinity propagation and DBSCAN are evaluated for a database of 361 images and gives reinforced results in the longitudinal B-mode ultrasound images. The proposed approach gives an improved accuracy of 12% increase when compared with the manual segmentation and 15% compared with segmentation by affinity propagation and DBSCAN when performed individually. The average Root Mean Square Error (RMSE) is 110 ± 44 µm.ConclusionExtracted edge points are used for clustering in a fully automated carotid artery segmentation approach.

Traffic-related NOx exposure and proximity to freeways are related to adverse changes in subclinical atherosclerosis measures from childhood to adulthood

Background: Chronic exposure to air pollutants is associated with increased risk of cardiovascular disease (CVD) among adults. However, little is known about how air pollution may affect the development of subclinical atherosclerosis in younger populations. Subclinical measures of atherosclerosis, including carotid artery intima-media thickness (CIMT) and arterial stiffness (CAS), may provide insight into early CVD pathogenesis. Methods: In a pilot study of 70 participants from the Southern California Children’s Health Study, we investigated subclinical atherosclerosis progression from childhood to adulthood. Using carotid artery ultrasound images obtained at age 10 and follow-up images from age 21-22, we examined associations between traffic-related pollutants and changes in CIMT and CAS. Lifetime average traffic-related NOx exposures were assigned using the CALINE4 (California Line Source) dispersion model. Distance to nearest roadways by class was assigned based on ESRI Streetmap Premium roadway data. Results: For each interquartile range increase in average lifetime NOx exposure, we observed a 12.12μm (95% CI: 1.11-23.13; p=0.03) increase in early adulthood attained CIMT and greater longitudinal changes in CIMT from childhood to adulthood (11.5μm, 95% CI: 1.29-21.73, p=0.03) over the follow-up period. Similar adverse changes in CIMT were observed with distance to nearest freeway. Changes in CAS were related to distance to freeway, such that living in closer proximity to freeways was related to greater adverse change in CAS over the follow-up period (stiffness index beta: 0.85; 95% CI: 1.50, 0.21, p=0.01; distensibility: -5.61; 95% CI: -0.93, -10.27, p=0.02).Conclusions: We observed greater adverse changes measures of carotid artery wall thickness and stiffness over time in relation to lifetime traffic-related NOx exposure and residential proximity to freeways. To our knowledge, this is the first study to evaluate the longitudinal impact of lifetime traffic-related air pollution exposure on changes in subclinical markers of atherosclerosis during the critical transition from childhood to adulthood.

Fully Automatic Measurement of Intima-Media Thickness in Ultrasound Images of the Common Carotid Artery Based on Improved Otsu's Method and Adaptive Wind Driven Optimization.

The intima media thickness (IMT) of the common carotid artery (CCA) can be used to predict the risk of atherosclerosis. Many image segmentation techniques have been used for IMT measurement. However, severe noise in the ultrasound image can lead to erroneous segmentation results. To improve the robustness to noise, a fully automatic method, based on an improved Otsu's method and an adaptive wind-driven optimization technique, is proposed for estimating the IMT (denoted as "improved Otsu-AWDO"). First, an advanced despeckling filter, i.e., " Nagare's filter" is used to address the speckle noise in the carotid ultrasound images. Next, an improved fuzzy contrast method (IFC) is used to enhance the region of the intima media complex (IMC) in the blurred filtered images. Then, a new method is used for automatic extraction of the region of interest (ROI). Finally, the lumen intima interface and media adventitia interface are segmented from the IMC using improved Otsu-AWDO. Then, 156 B-mode longitudinal carotid ultrasound images of six different datasets are used to evaluate the performance of the automatic measurements. The results indicate that the absolute error of proposed method is only 10.1 ± 9.6 (mean ± std in μm). Moreover, the proposed method has a correlation coefficient as high as 0.9922, and a bias as low as 0.0007. From comparison with previous methods, we can conclude that the proposed method has strong robustness and can provide accurate IMT estimations.

Segmentation of the Common Carotid Intima-Media Complex in Ultrasound Images Using 2-D Continuous Max-Flow and Stacked Sparse Auto-encoder

The intima-media thickness (IMT) of a common carotid artery in an ultrasound image is considered an important indicator of the onset of atherosclerosis. However, it is challenging to segment the intima-media complex (IMC) directly in ultrasound images. This study proposes a fully automatic method to segment the IMC on longitudinal B-mode ultrasound images. Our method consists of two stages: (i) extraction of the region of interest with a continuous max-flow algorithm and region-of-interest reconstruction using a stacked sparse auto-encoder model, and (ii) IMC segmentation using a trained random forest classifier. The proposed method has been tested on three databases from three different imaging centres, comprising a total of 228 ultrasound images of the common carotid artery. On the three databases, our method yields mean absolute errors of 0.028 ± 0.016 mm, 0.579 ± 0.288 pixel and 0.582 ± 0.341 pixel; polyline distance (PD) measures of 0.026 ± 0.017 mm, 0.657 ± 0.275 pixel and 0.731 ± 0:282 pixel; Hausdorff distance measures of 0.249 ± 0.101 mm, 4.760 ± 1.085 pixels and 5.825 ± 2.059 pixels; and correlation coefficients of 95.19%, 93.79%, and 98.96%, respectively. These results indicate that the proposed method performs well in segmentation of the IMC and measurement of the IMT.

Performance evaluation of unpreprocessed and pre-processed ultrasound images of carotid artery using CNN algorithm

Detection of plaques is an important task especially those which are prone to rupture and may dislocate to some other body parts. Also early detection reduces the risk of cardiac and cerebrovascular anomalies. Due to its wide availability and low cost, ultrasound images of carotid artery has the ability and potential to gain the preference over other resources for plaque detection and analysis in medical practice. However, the difficulty caused in automated techniques to identify plaques is significantly due to image noise, plaque size and the complex appearance of tissues comprising a plaque. So, in this paper, we have addressed this problem by using deep learning techniques such as CNN algorithm. Here we will build a CNN (Convolutional Neural Network) that will extract features from the dataset of images thereby giving detailed information which will help the clinicians to identify the abnormalities and constituents of different plaques in an image and report the image as “normal” or “abnormal”. In this paper we have used approximately 1000 images (JPG format) of 100 cases to process and has validated the proposed convolutional neural network (CNN). The process of cross-validation with the clinical assessment showed a correlation of about 0.75 for the detection of plaque. This results indicate the potential of deep learning techniques in medical fields, here, automatic detection of anomalies in carotid ultrasound images.

Automatic Segmentation of Lumen Intima Layer in Longitudinal Mode Ultrasound Images.

We propose an automated method for the segmentation of lumen intima layer of the common carotid artery in longitudinal mode ultrasound images. The method is hybrid, in the sense that a coarse segmentation is first achieved by optimizing a locally defined contrast function of an active oblong considering its five degrees-of-freedom, and subsequently the fine segmentation and delineation of the carotid artery are achieved by post-processing the portion of the ultrasound image spanned by the annulus region of the optimally fitted active oblong. The post-processing includes median filtering and Canny edge detection to retain the lumen intima representative points followed by a smooth curve fitting technique to delineate the lumen intima boundary. The algorithm has been validated on 84 longitudinal mode carotid artery ultrasound images provided by the Signal Processing laboratory, Brno university. The proposed technique results in an average accuracy and Dice similarity index of 98.9% and 95.2%, respectively.

Increased carotid artery wall stiffness and plaque prevalence in HIV infected patients measured with ultrasound elastography.

Assess carotid artery strain and motion in people living with HIV as markers of premature aging using ultrasound noninvasive vascular elastography (NIVE). Seventy-four HIV-infected and 75 age-matched control subjects were recruited from a prospective, controlled cohort study from October 2015 to October 2017 (mean age 56years±8years; 128 men). NIVE applied to longitudinal ultrasound images of common and internal carotid arteries quantified the cumulated axial strain, cumulated shear strain, cumulated axial translation, and cumulated lateral translations. The presence of plaque was also assessed. An association between elastography biomarkers and HIV status was evaluated with Mann-Whitney tests and multivariable linear regression models. A higher occurrence of carotid artery plaques was found in HIV-infected individuals (p= 0.011). Lower cumulated lateral translations were found in HIV-infected subjects on both common and internal carotid arteries (p=0.037 and p=0.026, respectively). These observations remained significant when considering multivariable models including common cardiovascular risk factors and clinical characteristics (p<0.05). Lower cumulated axial strains were also observed in internal carotid arteries when considering both multivariable models (p<0.05). Lower translation and strain of the carotid artery wall in HIV-infected individuals indicates increased vessel wall stiffness. These new imaging biomarkers could be used to characterize premature atherosclerosis development. • Noninvasive vascular elastography (NIVE) based on ultrasound imaging quantifies translations and strains of carotid arteries. • Lower translation and strain of the carotid artery wall found in HIV-infected individuals indicate premature arterial stiffening, compared with age-matched controls. • Carotid artery plaques were more prevalent in HIV-infected individuals than in control subjects.

Filtering and Detection of Intima-media Thickness (IMT) for the risk of Carotid Artery Atherosclerosis

Ultrasound images of carotid artery in brightness mode (B-mode) are used to detect the probabilities of atherosclerosis and cardiovascular diseases. They are used to measure the intima-media thickness (IMT). Ultrasound images suffer from peculiar phenomena which creates speckle (a type of noise) on the image. The speckles present in the medical images detoriates the quality of the image. This paper presents a work which is used to remove the speckles by utilizing the local characteristics of the image in the filter named as local statistics mean variance (lsmv) filter. It is a preprocessing step of medical image processing. Conventional IMT was done by locating the far walls of the carotid artery. This can be changed by applying segmentation algorithm which could automatically detect the far walls and could measure the IMT. This paper approaches towards automatic edge detection method using Prewitt operator. The objective behind automatically calculating IMT of carotid artery is to reduce the human effort and at the same time would benefit the patient by diagnosing the patient condition. The work that is proposed is analyzed by calculating various parameters in case of despeckling (filtering) as well as segmentation method. The performance parameters show that the proposed method performs better and at the same time reduces the manual effort

Application of Cardinal Points Symmetry Landmarks Distribution Model to B-Mode Ultrasound Images of Transverse Cross-section of Thin-walled Phantom Carotid Arteries

We had earlier developed a technique based on cardinal point symmetry landmark distribution model (CPS-LDM) to completely characterize the Region of Interest (ROI) of the geometric shape of thick-walled simulated B-mode ultrasound images of carotid artery imaged in the transverse plane. In this paper, this developed technique was applied to completely characterize the region of interest of the geometric shape of B-mode ultrasound images of thin-walled phantom carotid artery imaged in the transverse plane. The developed model employs a combination of fixed landmarks (FLs) and movable landmarks (MLs) to obtain the total landmarks (TLs) that can sufficiently segment the shape of the ROI of the carotid artery. For the phantom carotid arteries, three FLs are fixed on each of the four ROIs determined by the cardinal points North (N), South (S), East (E) and West (W) drawn on the ROIs of the phantom carotid artery. The MLs are determined by the inter-cardinal directions such as North-East (NE), North-West (NW) and so on. The obtained CPS-LDM equation developed allows graphical visualization the optimum number of points that can sufficiently segment the ROIs. ImageJ2 software was used to generate the Cartesian coordinates for each landmark which were then used to generate the Shape Space Pattern (SSP) of the phantom carotid artery ready for further statistical analysis. The results showed that the CPS-LD model is generic and adaptable to a variety of transverse cross-sectional B-mode ultrasound images of thin-walled phantom carotid artery

Application of Cardinal Points Symmetry Landmarks Distribution Model to B-Mode Ultrasound Images of Transverse Cross-section of Thin-walled Phantom Carotid Arteries

We had earlier developed a technique based on cardinal point symmetry landmark distribution model (CPS-LDM) to completely characterize the Region of Interest (ROI) of the geometric shape of thick-walled simulated B-mode ultrasound images of carotid artery imaged in the transverse plane. In this paper, this developed technique was applied to completely characterize the region of interest of the geometric shape of B-mode ultrasound images of thin-walled phantom carotid artery imaged in the transverse plane. The developed model employs a combination of fixed landmarks (FLs) and movable landmarks (MLs) to obtain the total landmarks (TLs) that can sufficiently segment the shape of the ROI of the carotid artery. For the phantom carotid arteries, three FLs are fixed on each of the four ROIs determined by the cardinal points North (N), South (S), East (E) and West (W) drawn on the ROIs of the phantom carotid artery. The MLs are determined by the inter-cardinal directions such as North-East (NE), North-West (NW) and so on. The obtained CPS-LDM equation developed allows graphical visualization the optimum number of points that can sufficiently segment the ROIs. ImageJ2 software was used to generate the Cartesian coordinates for each landmark which were then used to generate the Shape Space Pattern (SSP) of the phantom carotid artery ready for further statistical analysis. The results showed that the CPS-LD model is generic and adaptable to a variety of transverse cross-sectional B-mode ultrasound images of thin-walled phantom carotid artery

Relationship between Circulating Inflammatory Monocytes and Cardiovascular Disease Measures of Carotid Intimal Thickness.

Aims: Cardiovascular disease (CVD) remains the leading cause of death worldwide despite improvements in the treatment of atherosclerosis, an inflammatory disease and major underlying cause of CVD. Monocytes, an innate immune cell type, are linked to CVD progression; however, given their heterogeneity, the association between distinct monocyte subsets and increased risk of CVD remains unclear. This study investigated the association between peripheral monocyte subpopulation numbers and carotid intima-media thickness (cIMT), a sensitive measure of CVD risk, in a cohort of adults recruited from the general population.Methods: We used clinical data and peripheral blood mononuclear cell (PBMC) specimens from 67 individuals. cIMT was measured by high-resolution, B-mode, ultrasound images of the right carotid artery. PBMCs were stained with conjugated monoclonal antibodies to define monocyte subpopulations based on CD14 and CD16 co-expressions into classical (CD14++CD16−), intermediate/inflammatory (CD14++CD16+), and non-classical/patrolling (CD14low/+CD16++) monocytes.Results: We found a higher intermediate monocyte count was significantly correlated with increased right common carotid artery (RCCA) and right carotid bifurcation (RBIF) intima-media thickness (IMT) (p = 0.004 and 0.006, respectively), even after adjusting for CVD-associated clinical data (p = 0.006 and 0.004, respectively).Conclusion: Our study demonstrated a strong correlation between inflammatory monocyte counts and cIMT. These results suggest that, in the general population, there is a relationship between intermediate monocyte expansion and elevated predictors for CVD risk, and intermediate monocytes may be involved in the development of atherosclerosis and metabolic diseases. Strategies targeting inflammatory monocytes may be needed to slow CVD progression.

Developing patient-specific carotid artery ultrasound imaging phantoms for clinical training using 3D printing

Developing patient-specific carotid artery ultrasound imaging phantoms for clinical training using 3D printing

Changes in Carotid Duplex Ultrasound Velocities After Aortic Valve Replacement for Severe Aortic Stenosis.

The peak systolic velocity (PSV) and end-diastolic velocity (EDV) obtained by carotid duplex ultrasound (CDU) imaging of the internal carotid arteries (ICAs) are parameters used to determine the severity of ICA stenosis. Severe aortic stenosis (AS) results in a parvus-et-tardus pattern on spectral Doppler waveforms; however, the impact of severe AS on CDU velocities is unclear. The purpose of this study was to assess the impact of severe AS on CDU velocities by evaluating changes in CDU velocities before and after aortic valve replacement (AVR) METHODS: A single-center retrospective review of patients with severe AS who underwent surgical AVR and who had preoperative and postoperative CDU examinations performed within 12 months of each other was conducted. Patients with any carotid intervention between the preoperative and postoperative CDU were excluded. We identified 92 patients who satisfied all inclusion criteria. The mean age was 72.2 years; 71.7% were men; the mean preoperative aortic valve area ± SD was 0.8 ± 0.2 cm2 ; and the mean time from preoperative to postoperative AVR CDU was 182.3 ± 98.4 days. The peak aortic valve gradient decreased from 62.5 to 22.0 mm Hg after AVR (P < .001); however, there were no significant changes in the PSV or EDV in either the right or left ICA. Although severe AS may cause characteristic changes in the spectral Doppler waveform on CDU imaging, there is no significant effect on the ICA PSV or EDV. Adjustments in velocity criteria to determine the degree of carotid artery stenosis in patients with substantial AS may not be necessary.

Cardinal Points Symmetry Landmarks Distribution Model for Segmentation of Region of Interest in Simulated B-Mode Ultrasound Carotid Artery Images

Measurement accuracy and understanding of geometry of Common Carotid Artery (CCA) play an important role in carotid atherosclerosis assessment and management. In order to device techniques that can accurately analyze the effects of plaques on the carotid artery, a model that can sufficiently segment the Region of Interest (ROI) in the B-mode ultrasound image of carotid artery is needed. In this paper, a new Cardinal Points Symmetry Landmarks Distribution Model (CPS-LDM) to sufficiently segment the ROI in the carotid artery B-mode ultrasound imaged in the transverse plane is developed. The developed model employs a combination of fixed landmarks (FLs) and movable landmarks (MLs) to obtain the total landmarks (TLs) that can sufficiently segment the shape of the ROI of the carotid artery. Simulated ultrasound images are used. Four FLs are fixed on each of the four ROIs of the simulated carotid artery determined by the cardinal points North (N), South (S), East (E) and West (W) drawn on the ROIs of the carotid artery. The MLs are determined by the inter-cardinal directions such as North-East (NE), North-West (NW) and so on. The CPS-LDM equation developed allows us to visualize graphically the optimum number of points that can sufficiently segment the ROIs. ImageJ2 software was used to generate the Cartesian coordinates for each landmark which were then used to generate the Shape Space Pattern (SSP) of the carotid artery ready for further statistical analysis. The results showed that the CPS-LD model is sufficiently generic and adaptable to a variety of carotid artery B-mode ultrasound image simulated under different scenarios