Acuson s2000 9l4

Carotid and femoral arteries were assessed using a linear array transducer (Siemens Acuson S2000 9L4, 4–9 MHz) at high-resolution B-mode. Images of the common carotid artery (CCA) were obtained, and intima-media thickness (IMT) was measured 10 mm caudal of the carotid bulb at three different points. IMT was assessed for the both sides and averaged. Pulsed-wave-Doppler-mode was used to evaluate the flow-velocity of the internal carotid artery (ICA) and the common femoral artery (CFA). The ankle-brachial index was measured using a sphygmomanometer and Doppler probe. The score for both sides was calculated, and the lower one was chosen. The abdominal aorta was examined using a convex transducer (Siemens Acuson S2000 6C1 HD, 1.5–6 MHz). It was assessed in strict orthogonal orientation until the aortic bifurcation, and the largest outer-to-outer-wall diameter was assessed manually. Pulsed-wave-Doppler-mode was used to measure the peak systolic velocity.

All sonographic examinations were performed simultaneously with the other diagnostic evaluations (Acuson S2000, 9L4, Siemens Healthcare, Erlangen, Germany). B-mode sonography was performed on both parotid and submandibular glands. The echostructure of the parotid and submandibular glands in B-mode sonography was graded on a scale of 0–4 according to a previously published scoring system: grade 0: normal, homogeneous gland; grade 1: mild parenchymal inhomogeneity (PIH), hypoechoic areas <2 mm; grade 2: evident PIH, hypoechoic areas of 2–6 mm; grade 3: gross PIH, hypoechoic areas >6 mm; grade 4: adipose degeneration of the gland, adipose tissue echogenicity and parenchymal atrophy (11 (link), 18 (link)). The B-mode result was scored as abnormal if the score was 2 or higher, which had proved to be the optimal cut off in previous studies. Sonographic images representing the average echogenicity of the examined salivary gland were archived.