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(Stroke. 2001;32:1520.)
© 2001 American Heart Association, Inc.

Original Contributions

Accuracy of In Vivo Carotid B-Mode Ultrasound Compared With Pathological Analysis

Intima-Media Thickening, Lumen Diameter, and Cross-Sectional Area

Gernot Schulte-Altedorneburg, MD; Dirk W. Droste, MD; Szabolcs Felszeghy, DDS; Mónika Kellermann, MD; Vasile Popa, MD; Katalin Hegedüs, MD, PhD; Csaba Hegedüs, MD; Martina Schmid, MPH; László Módis, MD, PhD; E. Bernd Ringelstein, MD László Csiba, MD, PhD

From the Department of Neurology (G.S.-A., V.P., K.H., L.C.), the Department of Anatomy, Histology, and Embryology (S.F., L.M.), the Department of Psychiatry (M.K.), and the Department of Stomatology (C.H.), University of Debrecen, Medical and Health Science Centre, Faculty of Medicine, Debrecen, Hungary; the Department of Neurology (G.S.-A., D.W.D., E.B.R.), University of Münster, Münster, Germany; and the Institute for Medical Informatics, Biometry and Epidemiology (M.S.), University of Munich, Munich, Germany.

Correspondence to Gernot Schulte-Altedorneburg, MD, Department of Radiology, Klinikum Augsburg, Stenglinstr. 2, D-86156 Augsburg, Germany. E-mail Gernot.SAD{at}gmx.de

Background and Purpose—This study aimed to determine the correlation of in vivo ultrasound measurements of intima-media thickening (IMT), lumen diameter, and cross-sectional area of the common carotid artery (CCA) with corresponding measurements obtained by gross pathology and histology.

Methods—Sixty-six moribund neurological patients (mean age 71 years) underwent B-mode ultrasound of the CCA a few days before death. During autopsy, carotid specimens were removed in toto. Carotid arteries were ligated and cannulated for injection of a hydrophilic embedding material under standardized conditions. The carotid bifurcation was frozen and cut manually in 3-mm cross slices. Digital image analysis was carried out to determine the diameter and the cross-sectional area of the frozen slices of the CCA. IMT was assessed by light microscope. Ultrasonic and planimetric data were compared.

Results—Mean measurements of lumen diameter and cross-sectional area were 7.13±1.27 mm and 0.496±0.167 cm², respectively, by ultrasound, and 7.81±1.45 mm and 0.516±0.194 cm², respectively, by planimetric analysis of the unfixed redistended carotid arteries (R²=0.389 and 0.497). The mean IMT was 1.005±0.267 mm by ultrasound and 0.67±0.141 mm histologically, resulting in a mean difference of -31%.

Conclusions—Transcutaneous B-mode ultrasound provides a reliable approach for in vivo measurements of the cross-sectional area and, less exactly, of the lumen diameter of the CCA. Compared with histological results, in vivo ultrasound measurements of the IMT are systematically larger.

Key Words: carotid arteries • pathology • ultrasonography

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