The Role of Contrast-Enhanced Ultrasound in Managing Vascular Pathologies

Ultrasound is a useful first-line imaging modality for diagnosing and monitoring vascular pathologies. Compared with other modalities, it is relatively low cost, requires no ionizing radiation, is often available at bedside, and is noninvasive. However, the modality can have limitations when differentiating normal from pathologic tissues. In this review, we discuss the role of contrast-enhanced ultrasound (CEUS) in carotid, aortic, and peripheral vascular conditions.

CEUS is a developing modality that supersedes standard vascular ultrasound imaging and complements other modalities such as computed topography and magnetic resonance angiograms. Administered intravenously, the contrast are microbubbles filled with gas, surrounded by a stabilizing shell. They have the ability to enhance the quality of images and quantify vascular pathologies by acting as intravascular tracers of ultrasound energy. Based on these properties, CEUS has the potential to play a pivotal role in the management of vascular pathologies through its utility in detection, diagnosis, risk-stratification, follow-up, and monitoring.

Studies have suggested that CEUS is superior compared with standard ultrasound and on-par with computed topography angiograms in the detection of vascular pathologies, concluding that CEUS should be part of standardized routine practice.