Carotid ultrasound with intima-media thickness, commonly called CIMT or C-IMT, uses ultrasound to examine the carotid arteries in the neck. The study can measure artery-wall thickness and identify visible plaque without radiation, injections, or needles.
At HormoneSynergy® Clinic, carotid ultrasound images are obtained in our office and sent to VasoLabs for analysis. The resulting report may include average CIMT, right and left measurements, vascular age, percentile comparisons, plaque measurements, plaque location, ultrasound appearance, and historical comparisons when previous studies are available.
One-Minute Read
A carotid CIMT study provides information about the walls of the carotid arteries and any plaque that can be seen on ultrasound. CIMT is measured in millimeters. VasoLabs may also compare the measurement with age-based reference data and report a vascular age and percentile.
The percentile is not a measure of how blocked an artery is. It describes how artery-wall thickness compares with a reference population. Likewise, a plaque or “blockage” percentage displayed on a VasoLabs report should not be confused with the stenosis grade from a formal diagnostic carotid duplex examination.
Visible carotid plaque is evidence that atherosclerotic plaque is present. Its location, amount, ultrasound appearance, and change over time may provide additional context when evaluating cardiovascular risk. CIMT findings are most useful when considered together with blood pressure, apoB or LDL cholesterol, lipoprotein(a), glucose regulation, smoking history, family history, medications, symptoms, and other cardiovascular testing when appropriate.
A HormoneSynergy® CIMT study is used selectively for preventive cardiovascular assessment. It is not a substitute for diagnostic carotid duplex ultrasound or other cardiovascular imaging when those tests are clinically indicated.
What a Carotid CIMT Study Measures
The carotid arteries carry blood toward the brain. Ultrasound allows the vessel wall and surrounding anatomy to be viewed noninvasively while also showing whether focal plaque is visible.
- Intima-media thickness (IMT): the measured thickness of the inner layers of the carotid artery wall.
- Carotid plaque: focal buildup within the artery wall, including where it is located and how much is visible.
- Vascular age: an age-based comparison derived from the CIMT measurement and the reference population used by the reporting system.
- CIMT percentile: where the measured artery-wall thickness falls compared with the report's reference population.
- Change over time: when prior studies are available, current measurements can be compared with earlier results.
What to Expect During the Test
No special preparation is generally required. You will lie on your back while a small ultrasound probe is moved over the right and left sides of the neck with ultrasound gel. The examination commonly takes about 15 minutes and uses sound waves rather than radiation.
You can usually eat, drink, and take your regular medications normally unless you have been given different instructions.
Understanding the First Page of Your VasoLabs Report
The first page of a VasoLabs report may summarize three findings patients commonly notice first: vascular age, average carotid intima-media thickness, and the largest visible plaque measurement.
Vascular Age
Vascular age is an age-based estimate produced by comparing your CIMT result with population reference data. It should not be interpreted as your literal biological age or as a standalone diagnosis.
Carotid Intima-Media Thickness
CIMT is reported in millimeters. The report may provide an overall measurement along with separate right and left carotid measurements. Small differences between sides can occur.
Largest Plaque
If plaque is present, the report may identify the location of the largest measured plaque and describe its ultrasound appearance. A code such as LBULB, for example, refers to the left carotid bulb.
Where Carotid Plaque Can Be Seen
The carotid circulation includes several distinct regions. The VasoLabs artery map may identify plaque in the common carotid artery, carotid bulb, internal carotid artery, or external carotid artery.
- CCA: common carotid artery, the major carotid artery in the lower neck.
- Bulb: the widened area where the carotid artery divides. This is a common location for plaque.
- ICA: internal carotid artery, which travels toward the brain.
- ECA: external carotid artery, which supplies areas of the face, scalp, and neck.
Understanding Your CIMT Percentile
The CIMT percentile describes how your measured artery-wall thickness compares with the reference population used by the report. It does not describe the percentage of your artery that is blocked.
For example, a CIMT at the 75th percentile means the measured thickness is greater than or equal to that of roughly 75 percent of the comparison population. The VasoLabs report identifies the 75th percentile and above as high.
Percentile and plaque percentage describe different things. CIMT percentile compares artery-wall thickness with other people in the reference population. A plaque percentage on the VasoLabs report refers to visible plaque within a particular artery segment.
CIMT, Vascular Age, and Change Over Time
One advantage of repeating CIMT under comparable conditions is the ability to examine measurements over time. VasoLabs reports may display current and historical results against age-based male and female reference curves.
The graph can help place the measurement in context, but small numerical changes should not be interpreted in isolation. Imaging technique, measurement variability, plaque findings, age, and the broader cardiovascular picture all need to be considered.
Understanding the Plaque Table
When plaque is visible, the report may list the involved artery, plaque size, a displayed plaque or blockage percentage, plaque type, and a velocity field.
| Report Term | What It Means |
|---|---|
| Plaque size | The measured thickness or size of visible plaque, usually reported in millimeters. |
| Plaque / blockage % | VasoLabs' displayed estimate for visible plaque in the artery segment. It should not be treated as equivalent to a formal duplex stenosis grade. |
| Soft plaque | A term VasoLabs uses for plaque with a softer or less echogenic ultrasound appearance. |
| Heterogeneous plaque | Plaque with a mixed ultrasound appearance rather than one uniform pattern. |
| Calcified / echogenic plaque | Plaque that appears brighter on ultrasound, often because it contains more mineral or calcium. |
| Velocity | A blood-flow velocity field. Formal diagnostic carotid duplex examinations use Doppler velocity criteria when grading carotid stenosis. |
What the Ultrasound Images Show
The VasoLabs report may include the ultrasound images captured during the examination. Grayscale images display the vessel wall and surrounding anatomy. Color Doppler images visualize moving blood.
The red and blue colors on Doppler do not mean good versus bad blood flow, and they do not represent oxygenated versus deoxygenated blood. The colors primarily indicate the direction of blood flow relative to the ultrasound probe and the Doppler settings used during the study.
What Does Carotid Plaque Mean?
When carotid plaque is visible, atherosclerotic plaque is present within the carotid artery. The finding can add information to a preventive cardiovascular evaluation, particularly when interpreted alongside the amount and location of plaque, its ultrasound appearance, other cardiovascular risk factors, and changes seen on future studies.
No single CIMT measurement, vascular age, percentile, or plaque value should determine treatment on its own.
Dr. Kathryn Retzler may consider the CIMT findings together with blood pressure, apoB or LDL cholesterol, lipoprotein(a), glucose regulation, smoking history, family history, exercise, medications, symptoms, and other cardiovascular testing when appropriate.
What a CIMT Study Does Not Tell You
A HormoneSynergy® CIMT study analyzed by VasoLabs is not the same examination as a formal diagnostic carotid duplex ultrasound performed to evaluate suspected significant carotid stenosis, neurologic symptoms, or impaired blood flow using Doppler velocity criteria.
CIMT also does not replace coronary artery calcium scoring, coronary CT angiography, stress testing, or other cardiovascular studies when those tests are clinically indicated.
Where CIMT Fits in Preventive Cardiology
Professional guidelines do not support routine CIMT or carotid stenosis screening for every asymptomatic adult. At HormoneSynergy®, carotid ultrasound with CIMT is used selectively as one part of an individualized preventive cardiovascular assessment rather than as a universal screening test.
Its greatest value is context. A carotid ultrasound result becomes more clinically useful when it is considered alongside the rest of the patient's cardiovascular risk profile rather than treated as a standalone score.
Questions About Your Report?
Bring your VasoLabs report to your physician so the findings can be reviewed in the context of your medical history, laboratory testing, symptoms, medications, family history, and other cardiovascular imaging.
Frequently Asked Questions
Is CIMT the same as a carotid duplex ultrasound?
No. CIMT focuses on artery-wall thickness and visible plaque. A formal diagnostic carotid duplex examination uses Doppler blood-flow measurements and velocity criteria when evaluating suspected carotid narrowing or stenosis.
Does my CIMT percentile tell me how blocked my artery is?
No. CIMT percentile describes how artery-wall thickness compares with a reference population. It is not a percentage of arterial blockage.
What does vascular age mean?
Vascular age is an age-based comparison generated from your CIMT measurement relative to reference data. It should not be interpreted as your literal biological age.
What does visible carotid plaque mean?
Visible plaque indicates that atherosclerotic plaque is present in the carotid artery. Its significance depends on the amount, location, ultrasound appearance, overall cardiovascular risk profile, symptoms, and other testing.
Does CIMT use radiation?
No. Carotid ultrasound uses sound waves and does not involve ionizing radiation.
Can CIMT replace a coronary calcium scan or coronary CT angiogram?
No. These tests examine different aspects of cardiovascular disease. CIMT does not replace coronary artery calcium scoring, coronary CT angiography, or other cardiovascular testing when those studies are appropriate.
Educational Use Only: This page is intended for general education and is not a substitute for individualized medical evaluation, diagnosis, or treatment. Cardiovascular testing should be interpreted in the context of your history, symptoms, physical examination, medications, laboratory results, and other imaging when appropriate.
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