Contrast imaging ultrasound for the detection and characterization of carotid vulnerable plaque
- PMID: 32968654
- PMCID: PMC7487408
- DOI: 10.21037/cdt.2020.01.08
Contrast imaging ultrasound for the detection and characterization of carotid vulnerable plaque
Abstract
Not only the degree of luminal narrowing but also the plaque morphology and composition play an important role in risk stratification of carotid atherosclerotic lesions. During the last few years, carotid contrast-enhanced ultrasound (CEUS) has emerged as a valuable imaging tool to assess such vulnerable carotid plaques. This review article discussed the use of CEUS for the detection of carotid plaque irregularities and ulcerations as well as the quantification of intraplaque neovascularization and its correlation with histology and inflammatory biomarkers. Apart from evaluating for markers of vulnerable carotid plaques, CEUS enhancement is directly associated with past cerebrovascular events. More importantly, preliminary evidence has shown that CEUS could be used to predict future cerebrovascular and cardiovascular events. Despite the progress in CEUS imaging for carotid atherosclerotic disease, past studies still suffer from the retrospective nature, small sample size, and a lack of matched, well controlled prospective studies. In the future, large multi-center prospective studies addressing the relationship between CEUS findings and patient clinical outcomes in carotid atherosclerotic disease are warranted.
Keywords: Carotid plaque; contrast-enhanced ultrasound (CEUS); neovascularization; ulceration; ultrasound.
2020 Cardiovascular Diagnosis and Therapy. All rights reserved.
Conflict of interest statement
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt.2020.01.08). The series “Advanced Imaging in The Diagnosis of Cardiovascular Diseases” was commissioned by the editorial office without any funding or sponsorship. SP and DS serve as the unpaid editorial board members of Cardiovascular Diagnosis and Therapy from July 2019 to June 2021. DS reports grants from Bracco SA, outside the submitted work. PSS reports personal fees from Bracco SA, outside the submitted work. The authors have no other conflicts of interest to declare.
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