Contrast-Enhanced Ultrasound to Assess Carotid Intraplaque Neovascularization.

Area of Science:

• Vascular Medicine
• Medical Imaging
• Cardiovascular Surgery

Background:

• Carotid atherosclerosis poses a significant risk for stroke.
• Identifying vulnerable plaques is crucial for preventive therapy.
• Intraplaque neovascularization is a marker of plaque vulnerability.

Purpose of the Study:

• To systematically review the literature on carotid contrast-enhanced ultrasound (CEUS) for assessing intraplaque neovascularization.
• To provide a comprehensive overview of CEUS strengths and limitations in this application.
• To evaluate the correlation between CEUS findings and histopathological analysis.

Main Methods:

• Systematic literature review of 52 studies involving 4660 patients.
• Analysis of CEUS for intraplaque neovascularization assessment.
• Comparison of CEUS findings with histopathology in 17 studies (576 patients).

Main Results:

• CEUS is a readily available imaging modality for carotid atherosclerosis.
• Contrast enhancement on CEUS correlates with the presence and degree of intraplaque neovascularization.
• Higher CEUS enhancement indicates increased microvessel density on histology.

Conclusions:

• CEUS provides clinically relevant information on carotid atherosclerotic plaques, including ulceration and neovascularization.
• CEUS aids in early identification of high-risk carotid atherosclerosis.
• The goal is to initiate preventive therapy and reduce stroke risk.