This demo show cases a study of a carotid ultrasound sequence. The resulting 2 sets of measurement are:

• Vessel diameter - defined as the distance between the 2 M-lines (media-adventitia interface) on the near and far wall.
• Far wall IMT - defined as the distance between the I-line (intima-media interface) and the M-line on the far wall. Three IMT measurements are reported on an image frame: minimum, maximum and average.

Data

The images were acquired from a healthy female volunteer. Her common carotid was imaged.. Acquisition was not ECG-gated. Image data was stored on a CD-ROM in DICOM format. The DICOM clip contained 80 image frames.

The same artery segment is shown below from the first 4 frames:

1st frame	2nd frame
3rd frame	4th frame

1. Load Image Data
   A new study is created using the image data directly loaded from the DICOM CD-ROM. Once loaded Carotid Analyzer allows flexible playback or frame by frame review of the sequence of 80 frames. Subject information is extracted automatically from the DICOM file, i.e., subject name, imaging date, and calibration factors.
2. Define a Region of Interest (ROI)
   This process takes only a few seconds with the aid of an intuitive user interface.
   • Pick a frame with good image quality.
   • A 10 mm wide ROI is placed to indicate the segment of artery for measurement. The same ROI is used for all image frames of the sequence. The ROI has 2 parts, the near wall section and the far wall section. ROI definition (size, location, orientation can be changed with a mouse click)
   • Carotid Analyzer automatically learns the image characteristics within the ROI and adjusts its parameters.
     
3. Measure
   This step is automated. Carotid Analyzer goes through every frame, identifies the near and far borders (M-lines and I-lines), and performs the diameter and IMT measurement.
   
   Depending on the computer speed, it normally takes less than a second to analyze a frame.

   Results (boundaries and measurements) are displayed on the image for an immediately review.

   The M- and I-lines are overlaid on image. M-line is shown in purple. I-line is shown in yellow, both thickened for better visibility



4. Review
   Review of results can be based on the sequential plot of the diameters and IMT's, and the detected wall boundaries on each frame. If detection errors are found, the boundaries can be edited easily and measurements re-adjusted automatically.

   No editing is needed in this study

5. Report
   For the research version, the report can be saved as a native Microsoft Excel file, or a formatted text file for importing to SAS and other statistical packages. What to include in the report can be customized. In this study we choose to report, for each frame, the average vessel diameter, the minimum, maximum and average IMT of the far wall. Click to download the report in Excel format.

   For the clinical version, the report captures an image snapshot of the carotid segment with the I- and M-lines overlaid, and the plot of the IMT measurement based on the vascular age. The report can be directly printed from the Carotid Analyzer software, or saved into a Microsoft Word document. Click here to see a sample directly printed, or here for the same sample saved as a Word file.

6. Additional Quantitative Analysis
   Carotid Analyzer for Research also allows to determine Arterial distensibility, Arterial compliance, Incremental elastic modulus, Normalized plaque echodensity.

It is easy. It is accurate. And it is reliable!

Notice the cardiac motion captured by Carotid Analyzer's diameter measurement. The consistent re-construction of the cardiac motion can only be achieve by a highly accurate and reliable wall boundary detection algorithm. If systolic and diastolic blood pressure is available, vessel compliance indices can be derived.

IMT measurement confidence is achieved by: Accurate and reliable performance of the Carotid Analyzer. The IMT is measured as 0.5 mm, consistently across the entire sequence. Notice the small periodic changes of plaque thickness corresponding with the cardiac cycle - this sensitivity is impossible to achieve using manual analysis. Measuring IMT from a sequence spanning several cardiac cycles. Imaging artifacts (probe motion, etc.) has minimal effect on the results.

Request a DEMO CD
We provide a Vascular DEMO CD upon request. The CD allows you to install Brachial Analyzer and Carotid Analyzer DEMO software on your computer. The DEMO software is a time-locked version with full functionalities until expiration. You may try the software on your own image data, or a rich set of samples on the DEMO CD.

To request a DEMO CD, send an email to info@mia-llc.com.