Transcutaneous very-high resolution ultrasound for the quantification of carotid arterial intima-media thickness in children - Feasibility and comparison with conventional high resolution vascular ultrasound imaging

ObjectiveTo study the accuracy and feasibility of very-high resolution ultrasound (VHRU, 25-55 MHz) and conventional high resolution ultrasound (HRU, 12 MHz) in the assessment of common carotid intima-media thickness (IMT) in healthy children between 0 and 18 years of life.MethodsIMT was measured with VHRU and HRU in 135 children. Seventeen similar sized porcine arterial specimens were imaged with VHRU and HRU, and the IMT measurements compared to histology.ResultsAdequate imaging was obtained and IMT quantified in all children with 25 and 35 MHz, but the far wall was rarely reached with 55 MHz, even in small children. HRU-IMT was significantly thicker compared with VHRU-IMT in young children (<12 years; HRU: 0.434 ± 0.040 vs. VHRU: 0.341 ± 0.054 mm, N = 66; p < 0.001). No differences between HRU-IMT and VHRU-IMT were found among older children. No differences were found between far and near wall VHRU-IMT. An increase in porcine arterial IMT with decreasing transducer frequency was observed in comparison to histology. HRU-IMT was significantly overestimated compared with VHRU-IMT and histology-IMT in porcine vessels with an IMT within the pediatric range (0.20-0.50 mm).ConclusionVHRU is feasible and more accurate than HRU in quantifying CIMT in young children (<12 years). We recommend using the highest ultrasound transducer frequency applicable to quantify CIMT in the pediatric population.

▸ Conventional high resolution ultrasound is inaccurate in the assessment of carotid IMT in young children. ▸ Very-high resolution ultrasound frequencies are needed to quantify IMT during infancy and childhood. ▸ Very-high resolution ultrasound is feasible in quantifying carotid IMT in children of all ages.