Carotid Intima Media Thickness and Beyond

Jacques   D.   Barth

Abstract

Atherosclerosis evolves from the vascular wall. The initial build-up starts at the inner layers of the intima media complex of the artery. To track these phases of the beginning of disease requires a technique that can reliably detect and follow the extent and severity non-invasively over time. The artery that is accessible and indicative for the process of atherosclerosis is the carotid artery. The Quantitative assessment of the Intima Media Thickness (IMT) using ultrasound is safe, validated and portable, is inexpensive, and can be used in multicenter studies. IMT coupled with an interactive large multi-ethnic may provide a reliable tool to predict the likelihood of cardiovascular complications like myocardial infarction or stroke. QIMT combines the quantitative analyses and assessment of the far wall of the common carotid artery in a specific area, proximal to the bulb, that includes a fully automatic algorithm interacting with an ethnically diverse database. Many new and exciting applications where the underlying disease has an impact on cardiovascular disease have been added to its cardiovascular current use. The standardization of the whole procedure from image acquisition, transport of images, computerized assessment of images and interactive assessment for a specific individual is critical in its new and expanded role. Unfortunately the vast majority of the current systems do not adhere to these requirements, leading to a false sense of security when a value is provided. Given the lack of standardization in most IMT programs, a new valid standard is urgently needed, with the dissemination of these new concepts of application happens. The QIMT method of assessment of the far wall of the common carotid artery is validated, reproducible and the preferred method proposed for standardization. Different specialties should be approached and contribute in the expansion of its use, as opposed to the current trend to limit QIMT to specific healthcare areas.

Keywords: atherosclerosis, intima media thickness, qimt method, carotid artery

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