Technology Insight: ultrasound measurement of carotid plaque--patient management, genetic research, and therapy evaluation.

摘要: Atherosclerosis, which is the underlying cause of a large proportion strokes, has traditionally been assessed by measuring carotid intima–media thickness. As David Spence discusses in this Review, however, ultrasound measurement plaque area and volume emerging as powerful new tool for atherosclerosis burden, it becoming evident that thickness reflect biologically genetically different aspects atherosclerotic process. Various methods have used to quantify atherosclerosis, beginning mid-1980s with (IMT), going on coronary calcification electron-beam CT, ultrasound, wall MRI. In recent years, become clear IMT, process, will respond differentially therapy. IMT represents mainly hypertensive medial hypertrophy; measure more predictive stroke than myocardial infarction, only weakly associated traditional risk factors. Carotid area, other hand, strongly factors, infarction stroke. A quantitative trait, called 'unexplained atherosclerosis', expresses extent an individual excess not explained or protected from Unexplained progression even genetic research, because age, accounts greatest baseline plaque, much less influence rate progression. Compared three-dimensional reduces two orders magnitude sample size duration treatment needed evaluate therapies. Measurement is, therefore, important patient management, research evaluation therapies prevention.