Contrast-Enhanced Ultrasound in Vascular and Interventional Radiology: Current Status and Future Perspective

Background: Ultrasound (US) is the modality of choice for the workup of many vascular pathologies based on a plethora of advantages. However, US has inherent limitations including limited spatial resolution, and lower sensitivity to slow blood flow and vascular luminal irregularities. For evaluation of vascular pathology, angiography has long been considered the gold standard. Cross-sectional imaging techniques have gradually replaced angiography for the evaluation of many vascular beds, currently being regarded as the diagnostic imaging modality of choice for diagnosis of virtually almost every vascular disease leaving angiography mainly for treatment purposes. The introduction of microbubbles as ultrasonographic contrast agents has rendered contrast-enhanced ultrasound (CEUS) an evolving valuable complementary technique with markedly increased diagnostic accuracy for assessing both the macro- and microvascular anatomy of the vasculature. CEUS has a safety profile which is much favorable when compared to other contrast agents. Due to its superior spatial and temporal resolution, ability for prolonged scanning and dynamic and real-time imaging, it provides clinically significant additional information compared to the standard Duplex US. Method(s): In this communication, we discuss the currently available literature regarding vascular applications of CEUS, with special attention to the abdominal aorta, briefly elaborate on CEUS technique and present cases in order to illustrate the added value in the diagnosis and treatment of aortic pathologies. Result(s): CEUS enables imaging of adventitial vasa vasorum providing additional clinical utility since adventitial vasa vasorum has important implications in the pathogenesis of vascular diseases. The recent advances of CEUS along with ongoing development of drug-eluting contrast microbubbles has allowed improved targeted detection and real-time ultrasound guided therapy for aortic vasa vasorum inflammation and neovascularization in animal models. Conclusion(s): CEUS is uniquely suited to comprehensively assess and potentially treat vascular diseases in the future.

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Artikel online veröffentlicht:
11. Mai 2021