European Radiology

, Volume 29, Issue 3, pp 1507–1517 | Cite as

Carotid stiffness and atherosclerotic risk: non-invasive quantification with ultrafast ultrasound pulse wave velocity

  • Zheng-Qiu Zhu
  • Ling-Shan Chen
  • Han Wang
  • Fu-Ming Liu
  • Yun Luan
  • Lin-Lin Wu
  • Niu Liu
  • Pin Wang
  • Hui HuangEmail author



To evaluate the value of ultrafast pulse wave velocity (ufPWV) for the quantitative assessment of carotid stiffness and its associated with atherosclerosis (AS) risk.


The present study included 233 patients with hyperlipoidaemia (AS risk group) and 114 healthy adults as the control group. The carotid (n = 694) intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS) and pulse wave velocity-end of systole (PWV-ES) were measured on sample images. Differences, distributive characteristics and correlation evaluation were assessed in patients (ages 18–29, 30–39, 40–49, 50–59, 60–69 and ≥70) and carotids (control group vs AS risk group).


The cIMT, PWV-BS and PWV-ES increased with age; PWV-ES and cIMT showed an early significant increase in the 30–39 years group, whereas PWV-BS displayed a significant increase at 40–49 years compared with the 18- to 29-years group. Besides, PWV-ES correlated well with age compared with PWV-BS and cIMT. For carotid level, cIMT, PWV-BS and PWV-ES measurements were higher in the AS risk group compared with control. To compare the value of ufPWV and cIMT in early AS assessment, we subdivided groups into cIMT subgroups using a cut-off thickness of 0.050 cm. PWV-ES measurements were higher in the AS risk group compared with the control in the 0.040–0.050 cm (not thickened) and 0.051–0.060 cm (thickened) cIMT subgroups.


Carotid ufPWV measurement at PWV-ES is a novel modality for the early diagnosis and quantitative assessment of arterial stiffness associated with atherosclerotic risk.

Key Points

ufPWV technique is real-time and well repeatable for assessing carotid stiffness

ufPWV measurements increase and correlate well with age

PWV-ES is a quantitative predictor for the early assessment of AS


Atherosclerosis Pulse wave velocity Carotid intima-media thickness Carotid arteries Arterial stiffness 





Common carotid artery


Carotid-femoral pulse wave velocity


Carotid intima-media thickness


Diastolic blood pressure


High-density lipoprotein






Low-density lipoprotein


Limits of agreement


Pulse wave velocity


Pulse wave velocity-beginning of systole


Pulse wave velocity-end of systole


Systolic blood pressure


Total cholesterol




Ultrafast pulse wave velocity



This work was supported by the Research Project of Jiangsu Province Hospital of TCM (grant number Y17048) and the Research Project of Jiangsu Province of TCM (grant number YB2015020).

Compliance with ethical standards


The scientific guarantor of this publication is Hui Huang, MD (Department of Ultrasound, Affiliated Hospital of Nanjing University of CM, Nanjing 210029, China).

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Pin Wang, PhD (Department of Endocrinology, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, China), kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2018_5705_MOESM1_ESM.docx (9.5 mb)
ESM 1 (DOCX 9775 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Zheng-Qiu Zhu
    • 1
  • Ling-Shan Chen
    • 2
  • Han Wang
    • 3
  • Fu-Ming Liu
    • 4
  • Yun Luan
    • 1
  • Lin-Lin Wu
    • 1
  • Niu Liu
    • 1
  • Pin Wang
    • 5
  • Hui Huang
    • 1
    Email author
  1. 1.Department of UltrasoundAffiliated Hospital of Nanjing University of CMNanjingChina
  2. 2.Department of RadiologyAffiliated Hospital of Nanjing University of CMNanjingChina
  3. 3.Department of GeratologyAffiliated Hospital of Nanjing University of CMNanjingChina
  4. 4.Department of CardiologyAffiliated Hospital of Nanjing University of CMNanjingChina
  5. 5.Department of EndocrinologySichuan Academy of Medical Science and Sichuan Provincial People’s HospitalChengduChina

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