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. 2025 Sep 1;23(1):19.
doi: 10.1186/s12947-025-00356-0.

Current status and advances in ultrasound evaluation of neovascularization within carotid artery plaques: a systematic review

Yang Yang  1   2 , Fangqin Liu  1 , Jiaojun Yan  3 , Yunhao Luo  1 , Qiuyun Huang  1   3 , Lang Qiao  4   5
Affiliations

Current status and advances in ultrasound evaluation of neovascularization within carotid artery plaques: a systematic review

Yang Yang et al. Cardiovasc Ultrasound. .

Abstract

Vulnerable plaques are significant risk factors for acute ischemic events, and intraplaque neovascularization (IPN) is an important indicator for evaluating plaque vulnerability. This review summarizes the importance of IPN in the assessment of carotid plaque vulnerability, the current status of ultrasound examination of IPN, and the technical advancements in ultrasound imaging of IPN, These techniques include: Superb micro-vascular imaging; Contrast-enhanced ultrasound; Plane wave ultra-sensitive blood flow imaging; Ultrasound-targeted microbubble destruction; Ultrasound Super-Resolution Imaging. Aiming to provide a reference for the prevention and treatment of ischemic cardiovascular and cerebrovascular events.

Keywords: Contrast-enhanced ultrasound (CEUS); Intraplaque neovascularization (IPN); Plane wave ultra-sensitive blood flow imaging (Angio PLUS); Superb micro-vascular imaging (SMI); Ultrasound super-resolution imaging (SRI); Ultrasound-targeted microbubble destruction (UTMD).

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
4 Category Classification of IPN by SMI. The 4-category Classification of IPN by SMI is illustrated as follows: a: Grade 0: No blood flow signal within the plaque. b: Grade 1: One or several punctate blood vessels visible within the plaque (indicated by arrows); c: Grade 2: Punctate blood vessels and 1–2 linear blood vessels detected (indicated by arrows); d: Grade 3: Multiple linear blood vessels visible within the plaque, with most penetrating through the plaque (indicated by arrows)
Fig. 2
Fig. 2
Four-Category Classification of IPN Enhancement on CEUS
See this image and copyright information in PMC

References

    1. Lyu Q, Tian X, Ding Y, Yan Y, Huang Y, Zhou P, Hui P. Evaluation of carotid plaque rupture and neovascularization by Contrast-Enhanced ultrasound imaging: an exploratory study based on histopathology. Transl Stroke Res. 2021;12:49–56. 10.1007/s12975-020-00825-w - PubMed
    1. Moreno PR, Purushothaman KR, Fuster V, Echeverri D, Truszczynska H, Sharma SK, Badimon JJ, O’Connor WN. Plaque neovascularization is increased in ruptured atherosclerotic lesions of human aorta: implications for plaque vulnerability. Circulation. 2004;110:2032–8. 10.1161/01.CIR.0000143233.87854.23 - PubMed
    1. Song Y, Dang Y, Wang J, Cai H, Feng J, Zhang H, Ruan L. Carotid intraplaque neovascularization predicts ischemic stroke recurrence in patients with carotid atherosclerosis. Gerontology. 2021;67:144–51. 10.1159/000511360 - PubMed
    1. Li Y, Zheng S, Zhang J, Wang F, Liu X, He W. Advance ultrasound techniques for the assessment of plaque vulnerability in symptomatic and asymptomatic carotid stenosis: a multimodal ultrasound study. Cardiovasc Diagn Ther. 2021;11:28–38. 10.21037/cdt-20-876 - PMC - PubMed
    1. Zhao L, Han Y, Che Y, Zhang X, Luo M, Li J. Diagnostic accuracy of Superb microvascular imaging for detecting intraplaque neovascularization: a systematic review and meta-analysis. Cardiovasc Diagn Ther. 2023;13:893–905. 10.21037/cdt-23-202 - PMC - PubMed

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