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(Stroke. 2004;35:864.)
© 2004 American Heart Association, Inc.

Original Contributions

Measurement of Carotid Plaque Volume by 3-Dimensional Ultrasound

From the Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada.

Correspondence to Aaron Fenster, PhD, Imaging Research Laboratories, Robarts Research Institute, PO Box 5015, 100 Perth Dr, London, Ontario, N6A 5K8, Canada. E-mail afenster{at}imaging.robarts.ca

Background and Purpose Measurement of carotid plaque volume and its progression are important tools for research and patient management. In this study, we investigate the observer variability in the measurement of plaque volume as determined by 3-dimensional (3D) ultrasound (US). We also investigate the effect of interslice distances (ISD) and repeated 3D US scans on measurement variability.

Materials and Methods Forty 3D US patient images of plaques (range, 37.43 to 604.1 mm³) were measured by manual planimetry. We applied ANOVA to determine plaque volume measurement variability and reliability. Plaque volumes were measured with 9 ISDs to determine the effect of ISD on measurement variability. Additional plaque volumes were also measured from multiple 3D US scans to investigate repeated scan acquisition variability.

Results Intraobserver and interobserver measurement reliabilities were 94% and 93.2%, respectively. Plaque volume measurement variability decreased with increasing plaque volume (range, 27.1% to 2.2%). Measurement precision was constant for ISDs between 1.0 and 3.0 mm, whereas plaque volume measurement variability increased with ISD. Repeated 3D US scan measurements were not different from single-scan measurements (P=0.867).

Conclusions The coefficient of variation in the measurement of plaque volume decreased with plaque size. The volumetric change that must be observed to establish with 95% confidence that a plaque has undergone change is 20% to 35% for plaques <100 mm³ and 10% to 20% for plaques >100 mm³. Measurement precision was unchanged for ISDs <3.0 mm, whereas measurement variability increased with ISD. Repeated 3D US scans did not affect plaque volume measurement variability.

Key Words: ultrasonography • carotid arteries • carotid artery diseases • carotid artery plaque • carotid stenosis

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