Yonsei Med J.  2020 Feb;61(2):129-136. 10.3349/ymj.2020.61.2.129.

Feasibility and Applicability of Wireless Handheld Ultrasound Measurement of Carotid Intima-Media Thickness in Patients with Cardiac Symptoms

Affiliations
  • 1Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea. heart@gilhospital.com
  • 2Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea.
  • 3Department of Medical Engineering, School of Medicine, Gachon University, Incheon, Korea.
  • 4Healcerion Co., Ltd., Seoul, Korea.

Abstract

PURPOSE
Routine screening for carotid intima-media thickness (CIMT) and cardiovascular (CV) disease in asymptomatic patients has been criticized for the high costs and large number of patients required for detecting one patient with coronary artery disease (CAD). In order to overcome the low cost-effectiveness thereof, we investigated the feasibility of an economic wireless handheld ultrasound (WHUS) device for CIMT measurement in symptomatic patients.
MATERIALS AND METHODS
A total of 100 consecutive patients with cardiac symptoms were enrolled. CIMT was measured in all patients. Coronary angiography was performed in 75 patients indicated for the exam.
RESULTS
The mean of maximal CIMT measured from left/right common carotid artery and bulb (max-CIMT) by the WHUS device showed excellent agreement [intraclass correlation coefficient (ICC)=0.960] with a standard ultrasound device and great interobserver repeatability (ICC>0.9 between all observers). Receiver operating characteristic curve analysis showed that the predictive power for CAD was improved when max-CIMT and plaque information (plaque≥2) was added [area under the curve (AUC): 0.838] to the traditional clinical CV risk factors (AUC: 0.769). The cutoff values for CAD prediction with the standard device and the WHUS device were 1.05 mm (AUC: 0.807, sensitivity: 0.78, specificity: 0.53) and 1.10 mm (AUC: 0.725, sensitivity: 0.98, specificity: 0.27), respectively.
CONCLUSION
max-CIMT measured by a WHUS device showed excellent agreement and repeatability, compared with standard ultrasound. Combined max-CIMT and plaque information added predictive power to the traditional clinical CV risk factors in detecting high-risk CAD patients.

Keyword

Carotid intima-media thickness; coronary artery disease; wireless technology; ultrasonography

MeSH Terms

Carotid Artery, Common
Carotid Intima-Media Thickness*
Coronary Angiography
Coronary Artery Disease
Humans
Mass Screening
Risk Factors
ROC Curve
Sensitivity and Specificity
Ultrasonography*
Wireless Technology
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