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PURPOSE The common carotid artery intima-media thickness (CCA-IMT) is usually measured using B-mode ultrasound images. A different approach for CCA-IMT detection is based on radio frequency (RF) multiple M-line analysis. MATERIALS AND METHODS The present study explores the relationship between B-mode and RF measurement of CCA-IMT, as well as the reproducibility of both methods in 136 patients recently diagnosed with cardiovascular disease. Within one session, repeated measurements were made in the distal CCA bilaterally, using the B-mode (averaged over 10 mm) and RF technique (averaging 12 M-lines over 14 mm). RESULTS The two methods correlate well (Pearson r = 0.765). The CCA-IMT values measured with B-mode and RF were 0.779 +/- 0.196 mm and 0.734 +/- 0.172 mm, respectively. B-mode CCA-IMT is significantly larger than RF CCA-IMT (mean difference of 0.045 mm, SEM 7.8 microm; t = 5.82; p < 0.001). In the multivariate regression analysis, carotid artery stenosis, inhomogeneous IMT and diabetes mellitus were the main predictors of differences between B-mode and RF CCA-IMT. The intrapatient variation for B-mode and RF-based CCA-IMT is comparable (0.05 +/- 0.04 mm and 0.07 +/- 0.05 mm, respectively). CONCLUSION CCA-IMT values measured with RF and B-mode have similar reproducibility and exhibit acceptable correlation, but RF CCA-IMT is significantly smaller. The difference between both methods is mainly due to advanced atherosclerosis. Hence, both methods can be used reliably to measure CCA-IMT in clinical practice.

Pediatric transplant patients are known to have vascular abnormalities. The calcification inhibitors matrix Gla protein (MGP) and fetuin-A play an important role in the pathophysiology of vascular calcification. In the cross-sectional study reported here, we examined the circulating levels of fetuin-A and MGP in children after renal transplantation compared to healthy children and the association of these factors with vascular properties of the carotid artery. Levels of MGP and fetuin-A together with vascular properties of the carotid artery were determined in 29 pediatric renal transplant recipients and 54 healthy controls. The level of fetuin-A was decreased in the transplant group relative to the control group (P = 0.005), whereas the level of MGP (both non-phosphorylated MGP and non-carboxylated MGP) did not differ between groups. The intima-media thickness (P < 0.001) and the elasticity (P = 0.002) of the carotid artery were significantly increased in children after renal transplantation compared to healthy children. No associations between vascular parameters and calcification inhibitors were found in either group. Circulating levels of MGP and fetuin-A could not be identified as independent predictors of vascular stiffness or other carotid artery parameters in pediatric renal transplant recipients. Future prospective studies in pediatric ESRD and transplant patients are needed to learn more about the role of calcification inhibitors in relation to the prevention of vascular damage.