| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 1997;28:2201-2207.)
© 1997 American Heart Association, Inc.
Articles |
Reproducibility of Ultrasound Assessment of Carotid Plaque Occurrence, Thickness, and Morphology
The Tromsø Study
From the Institute of Community Medicine, University of Tromsø (Norway).
Correspondence to Oddmund Joakimsen, Institute of Community Medicine, University of Tromsø, N-9037, Norway. E-mail oddmund.joakimsen{at}ism.uit.no
Background and Purpose Ultrasonography is increasingly used in vascular research, but there is limited information about the reproducibility of the ultrasound method for screening purposes. In this study the reproducibility of ultrasound assessment of carotid plaque occurrence, thickness, and morphology was examined within the setting of a population health survey.
Methods In 1994/1995, 6720 participants in the Tromsø Study, Norway, underwent B-mode ultrasound scanning of the right carotid artery. The between- and within-sonographer reproducibility of ultrasound assessment of plaque occurrence and thickness was estimated by repeated scanning of a random sample of 107 participants. The between- and within-sonographer reproducibility of plaque morphology classification (echogenicity, four categories and heterogeneity, two categories) was determined by repeated reading of videotaped images of 119 randomly selected arteries with plaques.
Results Between- and within-sonographer agreement on plaque
occurrence was substantial with 
values (95% CI) of 0.72 (0.60 to
0.84) and 0.76 (0.63 to 0.89), respectively. Reproducibility of plaque
thickness measurements was moderate, with mean absolute differences
ranging between 0.25 and 0.55 mm (coefficients of variation
between 13.8% and 22.4%). Agreement on plaque morphology
classification was high, with values ranging between 0.54 and
0.73.
Conclusions Population screening using B-mode ultrasound provides a valuable means for the detection and morphological evaluation of carotid plaques, whereas measurements of plaque thickness are subject to considerable measurement error.
Key Words: atherosclerosis • carotid arteries • ultrasonography
This article has been cited by other articles:
 |
|
 |
|
  S. H. Johnsen, O. Joakimsen, K. Singh, E. Stensland, S. H. Forsdahl, and B. K. Jacobsen Relation of Common Carotid Artery Lumen Diameter to General Arterial Dilating Diathesis and Abdominal Aortic Aneurysms: The Tromso Study Am. J. Epidemiol., February 1, 2009; 169(3): 330 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Johnsen, E. B. Mathiesen, O. Joakimsen, E. Stensland, T. Wilsgaard, M.-L. Lochen, I. Njolstad, and E. Arnesen Carotid Atherosclerosis Is a Stronger Predictor of Myocardial Infarction in Women Than in Men: A 6-Year Follow-Up Study of 6226 Persons: The Tromso Study Stroke, November 1, 2007; 38(11): 2873 - 2880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. J. Kullo and A. R. Malik Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification J. Am. Coll. Cardiol., April 3, 2007; 49(13): 1413 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Jorgensen, T. Jenssen, S. H. Johnsen, E. B. Mathiesen, I. Heuch, O. Joakimsen, E. Fosse, and B. K. Jacobsen Albuminuria as risk factor for initiation and progression of carotid atherosclerosis in non-diabetic persons: the Tromso Study Eur. Heart J., February 1, 2007; 28(3): 363 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Zureik, S. Czernichow, D. Courbon, J. Blacher, P. Ducimetiere, S. Hercberg, M. E. Safar, and P. Galan Parental Longevity, Carotid Atherosclerosis, and Aortic Arterial Stiffness in Adult Offspring Stroke, November 1, 2006; 37(11): 2702 - 2707. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E Seyahi, S Ugurlu, R Cumali, H Balci, N Seyahi, S Yurdakul, and H Yazici Atherosclerosis in Takayasu arteritis Ann Rheum Dis, September 1, 2006; 65(9): 1202 - 1207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J Roman, T. Z Naqvi, J. M Gardin, M. Gerhard-Herman, M. Jaff, and E. Mohler American Society of Echocardiography Report: Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society for Vascular Medicine and Biology Vascular Medicine, August 1, 2006; 11(3): 201 - 211. [PDF]
|
|
|
|
 |
|
 M. J. Roman, E. Moeller, A. Davis, S. A. Paget, M. K. Crow, M. D. Lockshin, L. Sammaritano, R. B. Devereux, J. E. Schwartz, D. M. Levine, et al. Preclinical carotid atherosclerosis in patients with rheumatoid arthritis. Ann Intern Med, February 21, 2006; 144(4): 249 - 256. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sztajzel, S. Momjian, I. Momjian-Mayor, N. Murith, K. Djebaili, G. Boissard, M. Comelli, and G. Pizolatto Stratified Gray-Scale Median Analysis and Color Mapping of the Carotid Plaque: Correlation With Endarterectomy Specimen Histology of 28 Patients Stroke, April 1, 2005; 36(4): 741 - 745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Johnsen, E. Fosse, O. Joakimsen, E. B. Mathiesen, E. Stensland-Bugge, I. Njolstad, and E. Arnesen Monocyte Count Is a Predictor of Novel Plaque Formation: A 7-Year Follow-up Study of 2610 Persons Without Carotid Plaque at Baseline The Tromso Study Stroke, April 1, 2005; 36(4): 715 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Jorgensen, O. Joakimsen, G. K. Rosvold Berntsen, I. Heuch, and B. K. Jacobsen Low Bone Mineral Density Is Related to Echogenic Carotid Artery Plaques: A Population-based Study Am. J. Epidemiol., September 15, 2004; 160(6): 549 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Zureik, P. Galan, S. Bertrais, L. Mennen, S. Czernichow, J. Blacher, P. Ducimetiere, and S. Hercberg Effects of Long-Term Daily Low-Dose Supplementation With Antioxidant Vitamins and Minerals on Structure and Function of Large Arteries Arterioscler Thromb Vasc Biol, August 1, 2004; 24(8): 1485 - 1491. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Jorgensen, T. Jenssen, O. Joakimsen, I. Heuch, O. C. Ingebretsen, and B. K. Jacobsen Glycated Hemoglobin Level Is Strongly Related to the Prevalence of Carotid Artery Plaques With High Echogenicity in Nondiabetic Individuals: The Tromso Study Circulation, July 27, 2004; 110(4): 466 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ehlermann, W. Mirau, J. Jahn, A. Remppis, and A. Sheikhzadeh Predictive Value of Inflammatory and Hemostatic Parameters, Atherosclerotic Risk Factors, and Chest X-Ray for Aortic Arch Atheromatosis Stroke, January 1, 2004; 35(1): 34 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cremonesi, R. Manetti, F. Setacci, C. Setacci, and F. Castriota Protected Carotid Stenting: Clinical Advantages and Complications of Embolic Protection Devices in 442 Consecutive Patients Stroke, August 1, 2003; 34(8): 1936 - 1941. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Denzel, K. Balzer, K.-M. Muller, F. Fellner, C. Fellner, and W. Lang Relative Value of Normalized Sonographic In Vitro Analysis of Arteriosclerotic Plaques of Internal Carotid Artery Stroke, August 1, 2003; 34(8): 1901 - 1906. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Zureik, J.-M. Bureau, M. Temmar, C. Adamopoulos, D. Courbon, K. Bean, P.-J. Touboul, A. Benetos, and P. Ducimetiere Echogenic Carotid Plaques Are Associated With Aortic Arterial Stiffness in Subjects With Subclinical Carotid Atherosclerosis Hypertension, March 1, 2003; 41(3): 519 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Isaksen, A Egge, K Waterloo, B Romner, and T Ingebrigtsen Risk factors for aneurysmal subarachnoid haemorrhage: the Tromso study J. Neurol. Neurosurg. Psychiatry, August 1, 2002; 73(2): 185 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Tegos, K. J. Kalomiris, M. M. Sabetai, E. Kalodiki, and A. N. Nicolaides Significance of Sonographic Tissue and Surface Characteristics of Carotid Plaques AJNR Am. J. Neuroradiol., September 1, 2001; 22(8): 1605 - 1612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B. Mathiesen, K. H. Bonaa, and O. Joakimsen Low Levels of High-Density Lipoprotein Cholesterol Are Associated With Echolucent Carotid Artery Plaques: The Tromso Study Stroke, September 1, 2001; 32(9): 1960 - 1965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Zureik, F. Kauffmann, P.-J. Touboul, D. Courbon, and P. Ducimetiere Association Between Peak Expiratory Flow and the Development of Carotid Atherosclerotic Plaques Arch Intern Med, July 9, 2001; 161(13): 1669 - 1676. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. B. Mathiesen, K. H. Bonaa, and O. Joakimsen Echolucent Plaques Are Associated With High Risk of Ischemic Cerebrovascular Events in Carotid Stenosis : The Tromso Study Circulation, May 1, 2001; 103(17): 2171 - 2175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.M. Sabetai, T.J. Tegos, A.N. Nicolaides, S. Dhanjil, G.J. Pare, and J.M. Stevens Reproducibility of Computer-Quantified Carotid Plaque Echogenicity : Can We Overcome the Subjectivity? Stroke, September 1, 2000; 31(9): 2189 - 2196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Joakimsen, K. H. Bonaa, E. B. Mathiesen, E. Stensland-Bugge, and E. Arnesen Prediction of Mortality by Ultrasound Screening of a General Population for Carotid Stenosis : The Tromso Study Stroke, August 1, 2000; 31(8): 1871 - 1876. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Baldassarre, E. Tremoli, M. Amato, F. Veglia, A. Bondioli, and C. R. Sirtori Reproducibility Validation Study Comparing Analog and Digital Imaging Technologies for the Measurement of Intima-Media Thickness Stroke, May 1, 2000; 31(5): 1104 - 1110. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Joakimsen, K. H. Bonaa, E. Stensland-Bugge, and B. K. Jacobsen Age and Sex Differences in the Distribution and Ultrasound Morphology of Carotid Atherosclerosis : The Tromso Study Arterioscler Thromb Vasc Biol, December 1, 1999; 19(12): 3007 - 3013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. S. Markus, M. Sitzer, D. Carrington, M. A Mendall, and H. Steinmetz Chlamydia pneumoniae Infection and Early Asymptomatic Carotid Atherosclerosis Circulation, August 24, 1999; 100(8): 832 - 837. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Demos, H. Alkan-Onyuksel, B. J. Kane, K. Ramani, A. Nagaraj, R. Greene, M. Klegerman, and D. D. McPherson In vivo targeting of acoustically reflective liposomes for intravascular and transvascular ultrasonic enhancement J. Am. Coll. Cardiol., March 1, 1999; 33(3): 867 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. C. Arnold, K. B. Modaresi, N. Thomas, P. R. Taylor, and T. S. Padayachee Carotid Plaque Characterization by Duplex Scanning : Observer Error May Undermine Current Clinical Trials Stroke, January 1, 1999; 30(1): 61 - 65. [Abstract] [Full Text] [PDF]
|
|