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Echo-Tracking Method Improves the Reliability in Flow-Mediated Dilation Assessment by Measuring Brachial Artery Reactivity

Abstract The purpose of the study was to compare the intraobserver and interobserver reliability and agreement for measurement of flow-mediated dilation (FMD) between B-mode method and echo-tracking (ET) method. Twenty healthy volunteers (mean age, 31.6 ± 9.2 years) underwent ultrasound examination by both B-mode and ET methods. Baseline brachial artery diameter, post–cuff release diameter, and FMD percent were assessed by each sonologist on 2 consecutive days. Reliability was assessed by intraclass correlation coefficients, and Bland-Altman plots were used to visually compare measurement bias and agreement by the 2 ultrasound methods. A total of 40 pairs of data were available for analysis. Excellent intraobserver and interobserver reliability values were found for all variables assessed by the 2 methods. The intraclass correlation coefficient values were higher for ET in both intraobserver and interobserver evaluations, but only for interobserver evaluations for post–cuff release diameter and FMD was there no overlap in the 95% confidence interval. The Bland-Altman plots showed that in 95% of the measurements, the percentage difference between ET and B-mode ultrasound techniques was within 18.1%, 19.4%, and 17.3% for baseline brachial artery diameter, post–cuff release diameter, and FMD percent, respectively. The results suggest that ET and B-mode methods are reproducible in assessing the FMD. The ET method improves the reliability of FMD assessment, but we cannot determine which measurement is better for FMD.