• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.169-179
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• 1994

B-mode ultrasound is being used to assess carotid atherosclerosis in epidemiological studies and clinical trials. Recently the interpretation of measurements made from ultrasound images has been questioned. This study examines the anatomical correlates of B-mode ultrasound of carotid arteries in vitro and in situ in cadavers. Twenty-seven segments of human carotid artery were collected at autopsy. pressure perfusion fixed in buffered 2.5% gluteraldehyde and 4% paraformaldehyde and imaged using an ATL UM-8 (10 MHz single crystal mechanical probe). Each artery was then frozen, sectioned and stained with van Gieson or elastin van Gieson. The thickness of the intima. media and adventitia were measured 'to an accuracy of 0.01 mm from histological sections using a calibrated eye graticule on a light microscope. Shrinkage artifact induced by histological preparation was determined to be 7.8%. Digitised ultra sound images of the artery wall were analysed off-line. The distance from the leading edge of the first interface ($LE_{1}$) to the leading edge of the second interface ($LE_2$) was measured using a dedicated programme. $LE_{1}$-$LE_{2}$ measurements were correlated against histological measurements corrected for shrinkage. Mean values for the far wall were: ultra sound $LE_{1}$-$LE_{2}$ (0.97 mm, S.D. 0.26), total wall thickness (1.05 mm, S.D. 0.37), adventitia (0.35 mm, S.D. 0.16), media (0.61 mm, S.D. 0.18). intima (0.09 mm, S.D. 0.13). Ultrasound measurements corresponded best with total wall thickness, rather than elastin or the intima-media complex. Excision of part of the intima plus media or removal of the adventitia resulted in a corresponding decrease in the $LE_{1}$-$LE_{2}$ distance of the B-mode image. Furthermore. increased wall thickness due to intimal atherosclerotic thickening correlated well with $LE_{1}$-$LE_{2}$ distance of the B-mode images. B-mode images obtained from the carotid arteries in situ in four cadavers also corresponded best with total wall thickness measured from histological sections and not with the thickness of the intima plus media. In conclusion, the $LE_{1}$-$LE_{2}$ distance measured on B-mode images of the carotid artery best represents total wall thickness of intima plus media plus adventitia and not intima plus media alone.

• Journal of the Korea Society for Simulation
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• v.16 no.1
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• pp.21-29
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• 2007

In this paper, we present a method of detecting the boundary of the intima-media complex for automated measurement based on dynamic programming from carotid artery B-mode ultrasound images and then show the experimental results. We apply the dynamic programming for determining the optimal locations that a cost function is minimized. The cost function includes cost terms which are representing image features such as intensity, intensity gradient and geometrical continuity of the vessel interfaces. Moreover, we improve the boundary continuity by applying the B-spline to smooth the rough boundary due to noise such as speckle, dropout and weak edges. The proposed method has obtained more accurate reproducible results than conventional edge-detection by considering multiple image features and ensures efficient automated measurement by solving the problems of the inter- and intra-observer variability and its inefficiency due to manual measurement.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.1
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• pp.6-13
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• 2005

Individual clinical significance of each layer of CCA (common carotid artery) has not been well studied. We intended to measure the intima thickness (IT), media thickness (MT), and intima-media thickness (IMT) of CCA separately and tried to analyze the clinical significance. One hundred fifty one consecutive patients (mean age: $57{\pm}15$ years; 77 males, 74 females) underwent CCA scanning using high-resolution ultrasound. The images were off-line analyzed using B-mode ultrasound image processing, devised for individual measurement of IT and MT as well as IMT. The mean coefficients of variation of new method measuring IT, MT, and IMT separately were 0.16% for IMT and 0.21% for both IT and MT. The IT (p < 0.01), MT (p < 0.01) as well as IMT (p < 0.001) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hypertension showed significantly thicker IT (p < 0.01), MT (p < 0.001), and IMT (p < 0.001) than that of the patients without hypertension. However, only IT was thicker in patients with smoking (p<0.01) than that of the patients without smoking.

• International Journal of Vascular Biomedical Engineering
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• v.4 no.2
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• pp.25-30
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• 2006

We intended to measure the IT, MT, and the IMT of carotid artery separately and tried to analyze the clinical significance. Two hundred and fifty consecutive patients (125 males, 125 females) underwent carotid artery scanning using high-resolution ultrasound. The images were off-line analyzed using B-mode ultrasound image processing, devised in our research. We measured the IT, MT, and IMT semi-automatically at the far wall of designated 1cm length of the right common carotid and calculated the average values over the 200 points. The IT (p < 0.05), MT (p < 0.05) as well as IMT (p < 0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hypertension showed significantly thicker IT (p < 0.05), MT (p < 0.01), and IMT (p < 0.01) than that of the patients without hypertension. However, only IT was thicker in patients with smoking (p < 0.05) than that of the patients without smoking. Smoking was associated only with intima while hypertension was associated with the all three layer's thickness. This result suggests the atherosclerotic process can be different by cardiovascular risk factors.

• The KIPS Transactions:PartA
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• v.14A no.2
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• pp.77-84
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• 2007

The intima media thickness(IMT) of the carotid artery from B mode ultrasound images has recently been proposed as the most useful index of individual atherosclerosis and can be used to predict major cardiovascular events. Ultrasonic measurements of the IMT are conventionally obtained by manually tracing interfaces between tissue layers. The drawbacks of this method are the inter and intra observer variability and its inefficiency. In this paper, we present a multiresolution snake method combined with the dynamic programming, which overcomes the various noises and sensitivity to initialization of conventional snake. First, an image pyramid is constructed using the Gaussian pyramid that maintains global edge information with smoothing in the images, and then the boundaries are automatically detected in the lowest resolution level by minimizing a cost function based on dynamic programming. The cost function includes cost terms which are representing image features and geometrical continuity of the vessel interfaces. Since the detected boundaries are selected as initial contour of the snake for the next level, this automated approach solves the problem of the initialization. Moreover, the proposed snake improves the problem of converging th the local minima by defining the external energy based on multiple image features. In this paper, our method has been validated by computing the correlation between manual and automatic measurements. This automated detection method has obtained more accurate and reproducible results than conventional edge detection by considering multiple image features.

• Progress in Medical Physics
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• v.16 no.4
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• pp.207-213
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• 2005

The severity of carotid Intima-media thickness (IMT) is an Independent predictor of atherosclerosis which causes transient cerebral ischemia, stroke, and coronary events such as myocardial Infarction. The IMT consists of Intima thickness (IT) and media thickness (MT). However, the Individual clinical significance of IT and MT has not been well studied. We devised a method of measuring IT, MT, and IMT using B-mode ultrasound Image processing technique for the diagnosis of atherosclerosis. To inspect the clinical significance of IT, MT, and IMT, one hundred forty-four consecutive patients (mean age; 57 years old, 72 males) were underwent common carotid artery scanning using high-resolution ultrasound. Results showed that, the IT (p<0.05), MT (p<0.05) as well as IMT (p<0.01) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hyperiension showed significantly thicker IT (p<0.01), MT (p<0.001), and IMT (p<0.001). However, only IT was thicker in patients with smoking (p<0.01). The IT (r=0.374, p=0.001), MT (r=0.433, p=0.000), and IMT (r=0.479, p=0.000) showed positive correlation with age. The coefficients of determination ($r^2$) were estimated to be $92.4\%$ for IMT and MT, $49.1\%$ for IMT and IT, and $27.4\%$ for IT and MT. This result suggests that the Intima layer of the carotid artery has a different physiology with the media layer.