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Departments of 1 Medicine and 2 Human Movement and Exercise Science, The University of Western Australia, Perth 6001; and Departments of 4 Cardiology and 3 Medical Physics, The West Australian Heart Research Institute Royal Perth Hospital, Perth 6000, Western Australia, Australia
Brachial artery ultrasound
is commonly employed for noninvasive assessment of endothelial
function. However, analysis is observer dependent and
susceptible to errors. We describe studies on a computerized
edge-detection and wall-tracking software program to allow more
accurate and reproducible measurement. In study 1, three
purpose-built Perspex phantom arteries, 3.00, 4.00, and 6.00 mm in
diameter, were measured with the software. There was a mean bias of 11 µm (P < 0.001 at each level) between known and measured values; the mean resolving power of the software was estimated
as 8.3 µm. In study 2, the mean intraobserver
coefficient of variation of repeated measures of flow-mediated dilation
(FMD) using the software (6.7%) was significantly lower than that for traditional manual measurements using the intima-lumen interfaces (24.8%, P < 0.05) and intima-media interfaces
(32.5%, P < 0.05). In study 3, 24 healthy
volunteers underwent repeat testing twice within 1 wk; the coefficients
of variation for between-visit reproducibility of FMD and response to
glyceryl trinitrate using the software were 14.7 and 17.6%,
respectively. Assuming 80% power and an 
of 0.05, eight subjects
with matched controls would be required, in a parallel designed study,
to detect an absolute 2.5% change in FMD. In summary, we have
developed a semiautomated computerized vascular ultrasound analysis
system that will improve the power of clinical intervention studies to
detect small changes in arterial diameter.
flow-mediated dilation; glyceryl trinitrate; high-resolution ultrasound; wall tracking
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