Ultrasound Methods in the Evaluation of Atherosclerosis: From Pathophysiology to Clinic

Area of Science:

• Vascular Ultrasound
• Cardiovascular Imaging
• Atherosclerosis Diagnostics

Background:

• Atherosclerosis is a primary cause of cardiovascular diseases like coronary artery disease and stroke.
• Silent plaque progression necessitates advanced surveillance tools for risk stratification.
• Current methods like B-mode and Doppler ultrasound offer initial plaque visualization and risk assessment.

Purpose of the Study:

• To review emerging ultrasound-based tools for atherosclerotic plaque surveillance.
• To highlight advanced imaging modalities for plaque characterization and risk evaluation.
• To discuss the role of novel techniques in managing atherosclerosis.

Main Methods:

• Review of conventional ultrasound (B-mode, Doppler) and carotid intima-media thickness (C-IMT) measurements.
• Evaluation of contrast-enhanced ultrasonography (CEUS) for plaque neovascularization.
• Assessment of emerging elastography techniques (strain, shear-wave) for arterial wall biomechanics.
• Consideration of intravascular ultrasound (IVUS) with virtual histology for invasive assessment.

Main Results:

• Conventional ultrasound provides rapid risk stratification based on stenosis and plaque echogenicity.
• CEUS enhances visualization and quantification of neovascularization, a marker of plaque instability.
• Elastography offers insights into arterial wall biomechanics, altered in atherosclerosis.
• IVUS provides detailed lesion assessment and therapy monitoring.

Conclusions:

• Advanced ultrasound techniques significantly enhance the ability to visualize, characterize, and assess risk associated with atherosclerotic plaques.
• These evolving technologies promise improved surveillance and personalized management of cardiovascular disease.
• Integrating these tools can lead to more accurate risk prediction and timely intervention for patients with atherosclerosis.