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

Figures

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  Fig. 1. Images of the WHUS device, carotid scans from both devices, and details on patient enrollment. (A) The WHUS device can be connected to cellphones or tablets through its built-in Wi-Fi feature from virtually anywhere. The carotid bulb and CCA of the same patient acquired by the (B) WHUS and (C) standard device. (D) The carotid intima-media thickness of a total of 100 patients with cardiac symptoms was evaluated both by the standard and WHUS devices. WHUS, wireless handheld ultrasound; CIMT, carotid intima-media thickness; CAD, coronary artery disease; CCA, common carotid artery.

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  Fig. 2. Interdevice agreement and proportional bias. (A) A plot showing the CIMT of the WHUS and the standard device. (B) A Bland-Altman plot of the relationship between the average of WHUS and standard device and differences between the two devices. m, mean of differences between the WHUS and standard device; max-CIMT, mean of the maximal values of carotid intima-medial thickness of a patient; WHUS, wireless handheld ultrasound.

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  Fig. 3. Relationship between maximal carotid intima-media thickness (max-CIMT) and the number of each patient's diseased coronary vessels.

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  Fig. 4. ROC curves for predicting high-risk CAD patients. (A) A plot showing the predictive power of traditional clinical risk factors alone (red), mean maximal CIMT measured from left/right CCA and bulb (max-CIMT), and carotid plaques ≥2, in addition to clinical risk factors, using the WHUS and the standard device, shown in blue and green, respectively. (B) The cutoff max-CIMT values and in predicting high-risk CAD patients using the standard (1.05 mm) and WHUS (1.10 mm) device. ROC, receiver operating characteristic; AUC, area under the curve; CAD, coronary artery disease; WHUS, wireless hand-held ultrasound.