Contrast-enhanced ultrasound of the carotid system: a review of the current literature

被引:55
作者
Rafailidis V. [1 ]
Charitanti A. [1 ]
Tegos T. [2 ]
Destanis E. [1 ]
Chryssogonidis I. [1 ]
机构
[1] Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, Thessaloníki
[2] 1st Neurological Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloníki
关键词
Atherosclerosis; Carotid; Contrast-enhanced ultrasound; Occlusion; Plaque; Stenosis;
D O I
10.1007/s40477-017-0239-4
中图分类号
学科分类号
摘要
Carotid disease is a major current health problem accounting for a significant part of stroke patients. Ultrasound with colour Doppler and spectral analysis is the primary imaging technique used for screening and diagnostic evaluation of the extracranial part of carotid arteries offering identification and grading of carotid disease. However, inherent limitations of this technique include flow-related artefacts like Doppler angle dependence and aliasing artefact which may sometimes hinder complete assessment of a stenotic part of the vessel, potentially failing to address clinically significant differential diagnosis issues. The intravenous use of microbubbles as an US contrast agent has been introduced for the supplementation of conventional technique. The value of contrast-enhanced ultrasound (CEUS) has been investigated in the evaluation of carotid disease leading to promising results. CEUS provides improved flow visualization free of artefacts and detailed plaque surface delineation, thus being able to accurately grade stenosis, identify carotid plaque ulcerations, differentiate occlusion from highly stenotic plaques and identify carotid dissection. Furthermore, microbubbles can be used to identify and grade intraplaque neovascularization, carotid wall inflammation in patients with arteritis, follow-up patients after carotid intervention and assist interventional procedures reducing the need for nephrotoxic contrast agents. The purpose of this review is to present and discuss the current literature regarding the various uses of CEUS in carotid arteries. © 2017, Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).
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页码:97 / 109
页数:12
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共 95 条
  • [1] Grau A.J., Weimar C., Buggle F., Et al., Risk factors, outcome, and treatment in subtypes of ischemic stroke: the German stroke data bank, Stroke, 32, pp. 2559-2566, (2001)
  • [2] Krogias C., Kerasnoudis A., Detection of microembolic signals and ultrasonic brain perfusion imaging in symptomatic carotid artery disease, Nevrologia-gr, 21, pp. 36-46, (2012)
  • [3] Eckstein H.H., Kuhnl A., Dorfler A., Et al., The diagnosis, treatment and follow-up of extracranial carotid stenosis, Dtsch Arztebl Int, 110, pp. 468-476, (2013)
  • [4] Kernan W.N., Ovbiagele B., Black H.R., Et al., Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association, Stroke, 45, pp. 2160-2236, (2014)
  • [5] Saba L., Anzidei M., Marincola B.C., Et al., Imaging of the carotid artery vulnerable plaque, Cardiovasc Intervent Radiol, 37, pp. 572-585, (2014)
  • [6] Adams H.P., Bendixen B.H., Kappelle L.J., Biller J., Love B.B., Gordon D.L., Marsh E.E., Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment, Stroke, 24, pp. 35-41, (1993)
  • [7] Bonati L.H., Nederkoorn P.J., Clinical perspective of carotid plaque imaging, Neuroimaging Clin N Am, 26, pp. 175-182, (2016)
  • [8] MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. European Carotid Surgery Trialists’ Collaborative Group, Lancet, (1991)
  • [9] Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis, N Engl J Med, 325, pp. 445-453, (1991)
  • [10] Naylor A.R., Rothwell P.M., Bell P.R., Overview of the principal results and secondary analyses from the European and North American randomised trials of endarterectomy for symptomatic carotid stenosis, Eur J Vasc Endovasc Surg, 26, pp. 115-129, (2003)