The use of ultrasonography and especially of contrast-enhanced ultrasonography (CEUS) in the diagnosis of vascular pathologies before and after interventions has significantly increased over the past years due to the broader availability of modern ultrasound systems with CEUS capabilities and more trained user experience in this imaging modality. For the preinterventional and postinterventional work-up of carotid diseases, duplex ultrasound as well as CEUS have been established as the standard-of-care examination procedures for diagnosis, evaluation, and follow-up. In addition to its use for carotid arterial diseases, ultrasonography has also become the primary modality for the screening of vascular pathologies. This review describes the most common pathologies found in ultrasonography of the carotid arteries, the abdominal aorta, and the femoral arteries.
Aorta, Abdominal ; Arteriovenous Fistula ; Carotid Arteries ; Carotid Artery Diseases ; Carotid Stenosis ; Contrast Media ; Diagnosis ; Femoral Artery ; Follow-Up Studies ; Mass Screening ; Pathology ; Plaque, Atherosclerotic ; Ultrasonography*

Anticoagulants ; therapeutic use ; Carotid Arteries ; diagnostic imaging ; pathology ; Cerebral Infarction ; diagnostic imaging ; drug therapy ; pathology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thromboembolism ; complications ; diagnostic imaging ; drug therapy ; Ultrasonography

OBJECTIVETo study the relationship between carotid atherosclerosis and cerebral infarction (CI).

METHODSBetween November 2008 and March 2009, 147 CI patients (CI group) and 48 patients with non-cerebrovascular diseases (control group) were enrolled from inpatients of Neurology Department of our hospital. The diagnostic criterion of thickened carotid intima was set as 1.0 mmcarotid plaque was as IMT 1.5 mm. Carotid atherosclerosis was divided into three levels: normal intima, thickened intima, and plaque formation. The color Doppler ultrasonography data of carotid arteries in all patients were analyzed and the severity of carotid atherosclerosis was compared between the two groups.

RESULTSIn the CI group, 36 (24.5%) patients had normal carotid intima, 22 (15.0%) had thickened carotid intima, and 89 (60.5%) had carotid plaque. In the control group, 22 (45.8%) patients had normal carotid intima, 4 (8.3%) had thickened carotid intima, and 22 (45.8%) had carotid plaque. The severity of carotid atherosclerosis in the CI group was higher than that in the control group (P = 0.022). There was significant difference in the constitution of carotid plaque between the two groups (P = 0.001); the CI group mainly had the soft plaque (55/89, 61.8%), whereas the control group mainly had the hard plaque (17/22, 77.3%). The first three common locations of carotid plaque in both groups were carotid bifurcation (CI group: 73.7%; control group: 64.1%), common carotid artery (CI group: 20.4%; control group: 25.6%), and internal carotid artery (CI group: 5.9%; control group: 10.3%). The location of carotid plaque between the two groups was not significantly different (P = 0.438). There was no difference in the carotid inner diameter or resistance index between the two groups (P > 0.05).

CONCLUSIONSCarotid atherosclerosis is to some extent able to reveal the atherosclerotic condition of cerebral arteries and act as an important predictor for the risk of CI. The color Doppler ultrasonography of carotid arteries can provide a convenient way for the prevention and treatment of CI.

Adult ; Aged ; Aged, 80 and over ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; complications ; epidemiology ; pathology ; Cerebral Infarction ; epidemiology ; etiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Ultrasonography, Doppler, Color

OBJECTIVES: The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. METHODS: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. RESULTS: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (> or =5 servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. CONCLUSIONS: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (> or =5 servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.
Adult ; Aged ; Atherosclerosis/etiology/*pathology ; Carotid Arteries/*pathology/ultrasonography ; Female ; Humans ; Male ; Meat/*adverse effects ; Metabolic Syndrome X/complications/*pathology/ultrasonography ; Middle Aged ; Republic of Korea ; Risk Factors ; Tunica Intima/pathology/ultrasonography ; Tunica Media/*pathology/ultrasonography

Aged ; Body Mass Index ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Artery Diseases ; diagnosis ; epidemiology ; etiology ; Cholesterol, HDL ; blood ; Fatty Liver ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Insulin Resistance ; Intercellular Signaling Peptides and Proteins ; blood ; Male ; Metabolic Syndrome ; complications ; Middle Aged ; Obesity ; complications ; Risk Factors ; Triglycerides ; blood ; Tunica Intima ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVEThe study aimed to explore the relationship between the carotid intima-media thickness (IMT), lipids, high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy) and other indices of laboratory and the traditional Chinese medicine (TCM) syndrome of dyslipidemia.

METHODSA total of 152 dyslipidemia patients and 8 healthy people (taken as the control group) were recruited. According to the theory of the TCM syndrome, 152 dyslipidemia patients were assigned to 4 groups: the stagnation of phlegm (SP) group, the blood stasis blocking channels (BSBC) group, the stagnation of phlegm and blood (SPB) group and the non-stagnation of phlegm and blood (NSPB) group. The carotid ultrasonic test, hs-CRP, Hcy, blood rheology and blood lipids were examined for all the recruited patients. The relationships among carotid IMT, laboratory indices and TCM syndrome of dyslipidemia were analyzed by the methods of F test and multiple linear regressions.

RESULTS(1) Carotid IMT was significantly different among groups of healthy people and different TCM syndromes. The sequence from lowest to highest was: healthy group, NSPB group, SP group, SPB group and BSBC group. (2) Triglyceride (TG) and blood rheology were significantly different between the groups of healthy people and different TCM syndromes. Among different TCM syndrome groups, TG and blood rheology in the NSPB group were the lowest, but were the highest in SPB group. (3) Hcy, very low density lipoprotein and TG were correlated with atherosclerosis of the carotid.

CONCLUSIONCarotid IMT, TG and blood rheology were closely correlated with the TCM syndrome of dyslipidemia. Atherosclerosis of the carotids would be prone to occur if one of these factors was heightened.

Adult ; Aged ; Biomarkers ; analysis ; blood ; C-Reactive Protein ; analysis ; Carotid Arteries ; anatomy & histology ; diagnostic imaging ; pathology ; Case-Control Studies ; Dyslipidemias ; blood ; diagnosis ; pathology ; Female ; Homocysteine ; analysis ; blood ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Organ Size ; Research Design ; Syndrome ; Triglycerides ; analysis ; blood ; Tunica Intima ; anatomy & histology ; diagnostic imaging ; pathology ; Ultrasonography

No abstract available.
Carotid Arteries/pathology/ultrasonography ; Carotid Artery Diseases/diagnosis/*etiology ; Diabetes Mellitus, Type 2/complications/diagnosis ; Fatty Liver/*complications/diagnosis/ultrasonography ; Humans ; Metabolic Syndrome X/complications/diagnosis ; Obesity/complications/diagnosis ; Risk Factors

BACKGROUND/AIMS: Non-alcoholic fatty liver disease (NAFLD) is closely associated with abdominal obesity, dyslipidemia, hypertension, and Type 2 diabetes, which are all features of the metabolic syndrome. The aim of the present study was to elucidate whether NAFLD is associated with carotid atherosclerosis. METHODS: The study population comprised 659 subjects without hepatitis B and C infections and who did not consume alcohol. Fatty infiltrations of liver were detected by abdominal ultrasonography, and intima-media thickness (IMT) and plaque prevalence were estimated by carotid ultrasonography. RESULTS: The mean values of systolic and diastolic pressures, body mass index (BMI), aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, uric acid, total cholesterol, triglycerides, high density lipoprotein (HDL) cholesterol, fasting glucose, fasting insulin, homeostasis model of assessment (HOMA) index, hemoglobin A1c, and plasminogen activator inhibitor-1 differed significantly between patients with NAFLD (n=314) and normal controls (n=345). The carotid IMT was 0.817+/-0.212 (mean+/-SD) mm in patients with NAFLD and 0.757+/-0.198 mm in normal controls (p<0.001). The prevalence of carotid plaques was higher in patients with NAFLD (26.4%) than in normal controls (15.9%) (p<0.001). This association persisted significantly after adjusting for age, sex, BMI, HOMA index and individual factors of metabolic syndrome by multiple logistic regression analysis. CONCLUSIONS: Patients with NAFLD are at a high risk of carotid atherosclerosis regardless of metabolic syndrome and classical cardiovascular risk factors. Therefore, the detection of NAFLD should alert to the existence of an increased cardiovascular risk. Moreover, NAFLD might be an independent risk factor for cardiovascular disease.
Aged ; Body Mass Index ; Carotid Arteries/pathology/ultrasonography ; Carotid Artery Diseases/diagnosis/*etiology ; Cholesterol, HDL/blood ; Demography ; Diabetes Mellitus, Type 2/complications/diagnosis ; Diabetic Diet ; Fatty Liver/*complications/diagnosis/ultrasonography ; Female ; Humans ; Male ; Metabolic Syndrome X/complications/diagnosis ; Middle Aged ; Obesity/complications/diagnosis ; Regression Analysis ; Risk Factors ; Triglycerides/blood

BACKGROUND/AIMS: Behcet's disease (BD) is a systemic disorder associated with a characteristic vasculitis that can involve both veins and arteries of all sizes. Endothelial activation or injury is a characteristic feature of BD. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis. The carotid artery intima-media thickness (IMT) is a widely accepted marker of subclinical atherosclerosis. We aimed to determine the carotid IMT in BD patients with using high-resolution B-mode Doppler ultrasonography. METHODS: We studied 40 patients (24 males, mean age: 39.1+/-8.5 years) who were diagnosed by the international diagnostic criteria of Behcet's disease and 20 healthy controls (13 males, mean age: 40.2+/-5.1 years), and the two groups were matched by age and gender. No subject in either group had a history of atherosclerosis or its complications. The clinical data, including the age of onset, the duration of disease, a history of medication, the activity score and the laboratory data were analyzed. RESULTS: The carotid IMT in the BD group was significantly higher than that in the control group (0.71+/-0.22 mm vs. 0.59+/-0.09 mm, respectively, p<0.01). Cardiac and major vessel involvements were not identified in the BD group. However, minor vascular involvements were documented in 2 patients with deep vein thrombosis, in 4 patients with superficial thrombophlebitis and in 2 patients with pseudoaneurysm. The carotid IMT in the patients with posterior uveitis or retinal vasculitis was higher than that of the patients without these findings (0.85+/-0.21 mm vs. 0.64+/-0.10 mm, respectively, p=0.007), but there was no difference of the IMT according to minor vascular involvement. CONCLUSIONS: Despite that there was no significant cardiovascular involvement in the BD patients, the carotid IMT was significantly higher in the BD patients as compared with the healthy controls.
Adult ; Behcet Syndrome/complications/diagnosis/*pathology ; Carotid Arteries/*pathology/ultrasonography ; Case-Control Studies ; Endothelium, Vascular/pathology ; Female ; Humans ; Male ; Prognosis ; Prospective Studies ; Risk Factors ; Tunica Intima/*pathology/ultrasonography ; Tunica Media/*pathology/ultrasonography ; Ultrasonography, Doppler ; Vasculitis/pathology

OBJECTIVETo observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS).

METHODSForty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intimamedia thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasonography before and after 6 months of treatment.

RESULTSAs compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r = - 0.596, P < 0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-endothelium-dependent dilation between the two groups.

CONCLUSIONA negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

Aged ; Atherosclerosis ; complications ; pathology ; physiopathology ; Carotid Arteries ; diagnostic imaging ; drug effects ; physiopathology ; Carotid Artery Diseases ; complications ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Treatment Outcome ; Ultrasonography