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MIDS 237 > Ch 14 IMT > Flashcards

Ch 14 IMT Flashcards

1
Q

When does atherosclerosis develop?

A

Slowly starting from childhood + proceeds into adulthood (pt’s are susceptible to complications)

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2
Q

What is the first structure detected by u/s indicating atherosclerosis?

A

Increased IMT (intimal media thickness)

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3
Q

Increased IMT is the result of what nonatherosclerotic processes?

A

-Smooth muscle cell hyperplasia
-Fibrocellular hypertrophy

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4
Q

List 3 reasons as to why there may be an increased IMT?

A

-Atherosclerosis
-Nonatherosclerotic processes
-Response to changes in flow, wall tension or lumen diameter

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5
Q

Who would get an IMT test?

A

Pt’s at moderate risk for having cardiovascular disease

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6
Q

IMT results are used in conjunction with what other 2 tests?

A

Calcium score test or framingham risk score

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7
Q

What is a calcium score test?

A

-CT scan that shows how much calcium is in coronary arteries
-Tells us if there is plaque in the arteries that can narrow/block them

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8
Q

What can atherosclerosis lead to?

A

Heart attack

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9
Q

What is the framingham risk score?

A

Tool for assessing the risk level of CAD over 10 years

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10
Q

What are the 6 coronary risk factors that the framingham risk score considers?

A

-Age
-Gender
-Total cholesterol
-High density lipoprotein cholesterol
-Smoking habits
-Systolic BP

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11
Q

When would an IMT measurement not be recommended?

A

-Not a routine measurement done in clinical for a risk assessment for a first time atherosclerotic cardiovascular disease event

-Serial IMT studies are not recommended

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12
Q

Which probe should we use for an IMT exam?

A

High frequency 12-15Mhz

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13
Q

Define IMT?

A

Double line pattern on both walls of the CCA in SAG

(the lumen-intima + media-adventitia interfaces form the 2 parallel lines)

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14
Q

What is the main challenge with IMT measurements?

A

Significant differences in how the measurement is performed

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15
Q

Should we use zoom when performing an IMT measurement?

A

No!

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16
Q

What are the standard IMT settings on the machine?

A

-B mode >7Mhz with minimal compression
-Footprint at least 3cm
-Focus depth (30-40mm)
-FR (>15-25 Hz)

17
Q

What landmark should be included in our IMT image to provide accurate serial measurements?

A

Carotid bif

18
Q

Where should we obtain our IMT measurement?

A

Segment free of atherosclerotic plaque with clearly defined lumenn-intima + media-adventitia interfaces

19
Q

How long is our IMT measurement?

A

10mm

20
Q

Is the far or near wall of the CCA better to measure?

A

Far wall

21
Q

What window is preferred for best resolution?

A

Lateral/coronal window

22
Q

Is insonation from multiple angles recommended?

A

No! Assess in SAG + perpendicular to beam

23
Q

The IMT measurement must be how many mm below the distal CCA?

A

5mm

24
Q

Is point-to-point measurement of IMT recommended?

A

No!

25
Q

Are IMT measurements automatic?

A

Automatic or semi-automatic, with automatic border detection software

26
Q

What other measurement is obtained with an IMT?

A

CCA diameter

27
Q

What part of ECG is IMT measured?

A

End diastole (R wave)

28
Q

Do we average or take the highest IMT measurement?

A

Average (mean IMT values preferred)

29
Q

How can we increase the reproducibility of IMT measurements?

A

When we combine the RT + LT CCA values

30
Q

How often should the u/s phantoms be used to determine accuracy of axial + lateral resolution?

A

Every 6 months

31
Q

Normal IMT values depend on what 2 factors?

A

Age + sex

(steady increase in IMT with age occurs in all carotid segments)

32
Q

Higher IMT values in men or women?

A

Men

33
Q

Explain the <25th, 25th-75th and >75th percentile ranges with IMT?

A

<25: low risk
25-75: average + unchanged cardiovascular risk
>75: high risk

34
Q

___ mm is a marker of asymptomatic organ damage?

A

> 0.9 mm

MIDS 237 (23 decks)

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