Morphometric Analysis of the Human Carotid Bifurcation and Intimal-Medial Thickness Using High-Resolution Ultrasonography

International Journal of Anatomy and Physiology | Vol. 15, No. 9, September 2026 | pp. 55–63

DOI: 10.46882/2026/IJAP/001007

Research Article

Title: Morphometric Analysis of the Human Carotid Bifurcation and Intimal-Medial Thickness Using High-Resolution Ultrasonography

Names of Authors: M. E. Larsen¹, J. A. Nkosi², C. H. Choi³*

Authors’ Affiliations:
¹ Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
² Department of Human Anatomy, University of the Witwatersrand, Johannesburg, South Africa.
³ Department of Anatomy, Yonsei University College of Medicine, Seoul, South Korea.

Abstract:
The geometric configuration of the carotid bifurcation influences local hemodynamic patterns, predisposing specific areas to atherosclerotic plaque development. This study evaluated the relationship between the geometric dimensions of the carotid bifurcation and carotid intima-media thickness (CIMT) in a healthy adult cohort. High-resolution B-mode ultrasonography was performed on 250 healthy volunteers (aged 20–60 years) to measure the diameters of the common carotid artery (CCA), internal carotid artery (ICA), and external carotid artery (ECA). The carotid bifurcation angle and the CIMT of the posterior CCA wall were quantified. The mean bifurcation angle across the cohort was 54.2° ± 8.6°. A statistically significant positive correlation was identified between wider bifurcation angles (>60°) and higher mean CIMT values (0.78 ± 0.11 mm vs. 0.62 ± 0.08 mm in angles <50°; p < 0.01). The ratio of the combined cross-sectional area of the ICA and ECA to that of the CCA (area ratio) averaged 1.15 ± 0.14. Lower area ratios (<1.0) correlated with elevated ICA intimal thickness, likely due to altered wall shear stress. Stepwise multiple regression analysis confirmed that the carotid bifurcation angle is an independent predictor of regional intima-media thickening, even after adjusting for age and gender. Mapping these anatomical dimensions using non-invasive ultrasound assists in identifying individuals with geometrically unfavorable vascular structures who may have a higher risk of developing carotid vascular diseases.

Keywords: Carotid bifurcation, Intima-media thickness, Ultrasonography, Hemodynamics, Carotid artery.

Manuscript Timeline: Received: June 22, 2026; Revised: August 01, 2026; Accepted: August 22, 2026; Published: September 26, 2026.

Citation: Larsen ME, Nkosi JA, Choi CH. Morphometric Analysis of the Human Carotid Bifurcation and Intimal-Medial Thickness Using High-Resolution Ultrasonography. International Journal of Anatomy and Physiology. 2026; 15(9): 55–63. doi:10.46882/2026/IJAP/001007

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