SONOGRAPHIC CORRELATION OF CAROTID INTIMA MEDIA THICKNESS AND HEPATIC ECHOTEXTURE WITH SERUM LIPID PROFILE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 30
Abstract
BACKGROUND Today ultrasound has emerged as a powerful diagnostic medical tool as it is cost effective, widely available and there is no risk of radiation. Driven by an increasing public awareness, as well as advances in treatment of dyslipidaemia, there has been a growing interest in the evaluation of carotid intima media for thickening and plaque and the assessment of liver echotexture for its fatty content by ultrasound over the last decade. Aims and Objectives: To document the presence/ absence of carotid intima thickening in patients. To document the presence/ absence of plaque. To document the presence/ absence of diffuse alterations in hepatic echotexture for fatty changes. Sex and age prevalence of carotid intima media thickening and hepatic echotexture changes. Statistical correlation of carotid intima medial thickness and hepatic echotexture changes with serum lipid parameters, if any. MATERIALS AND METHODS This prospective observational study was performed in the Department of Radiodiagnosis and Imaging, Dr. Somervell Memorial CSI Medical College, Karakonam in the period between January - August 2017. A series of 241 consecutive adult patients who presented to our routine master health check-up were included in our study. Ultrasound analysis of the carotid arteries was performed with a high-resolution linear array transducer. The maximal intima media thickness and the presence of plaque were looked for on both sides. Using a curvilinear array transducer, the echogenicity of the liver parenchyma was evaluated. Serum total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were estimated using enzymatic methods by a Hitachi 912 automated analyser. RESULTS A total of 241 patients, who presented to our routine master health check-up underwent sonography and serum lipid analysis for the purpose of the study. Majority of patients in study population were males (62%), while 38% were females. Of them, 150 were male and 90 were female. The mean age of the study sample was 55.1 years with a range of 19 - 83 years. Maximum 148 (61.4%) were in the age group of 41 - 60 years followed by > 60 years’ age group, which included 75 (31.2%). Least number of patients 1 (0.41%) were in the age group of < 20 years. Carotid intima media thickening was found to be more common in males (42%) than in females (29.6%). In the 41 - 60 years’ age group it was 31.7% and 57.3% in the > 60 years’ age group. Presence of plaques also showed a gradual rise in prevalence with age, 23.5% in the 21 - 40 years’ group, 33.1% in the 41 -60 years’ groups and 65.3% in the > 60 years’ group. In patients with increased CIMT, the prevalence rate of abnormal lipid parameters range between 39% as with abnormal LDL-cholesterol and 45% as with abnormal HDL-cholesterol levels. Of the 241 patients who were evaluated for liver echotexture changes 130 (54%) had diffusely increased echotexture, 111 (46%) had normal and none (0%) had decreased echotexture. CONCLUSION Twenty first century India is at a threshold of a cardiovascular atherosclerotic disease boom. Incidence of dyslipidaemia is on the rise. With the continuing rapid advances in ultrasound technology, sonography will continue to remain an effective diagnostic tool in the early assessment of carotid atherosclerotic disease and fatty liver disease.
Authors and Affiliations
Sebastian Varghese, Krishna Chaitanya Nunna
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