Contrast-enhanced ultrasound imaging of the vasa vasorum: from early atherosclerosis to the identification of unstable plaques.
Proliferation of the adventitial vasa vasorum (VV) is inherently linked with early atherosclerotic plaque development and vulnerability. Recently, direct visualization of arterial VV and intraplaque neovascularization has emerged as a new surrogate marker for the early detection of atherosclerotic disease. This clinical review focuses on contrast-enhanced ultrasound (CEUS) as a noninvasive application for identifying and quantifying carotid and coronary artery VV and intraplaque neovascularization. These novel approaches could potentially impact the clinician's ability to identify individuals with premature cardiovascular disease who are at high risk. Once clinically validated, the uses of CEUS may provide a method to noninvasively monitor therapeutic interventions. In the future, the therapeutic use of CEUS may include ultrasound-directed, site-specific therapies using microbubbles as vehicles for drug and gene delivery systems. The combined applications for diagnosis and therapy provide unique opportunities for clinicians to image and direct therapy for individuals with vulnerable lesions.
Staub
Daniel
D
Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, Illinois 60612, USA.
Schinkel
Arend F L
AF
Coll
Blai
B
Coli
Stefano
S
van der Steen
Antonius F W
AF
Reed
Jess D
JD
Krueger
Christian
C
Thomenius
Kai E
KE
Adam
Dan
D
Sijbrands
Eric J
EJ
ten Cate
Folkert J
FJ
Feinstein
Steven B
SB
D000818:Animals; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003238:Connective Tissue / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004195:Disease Models, Animal; D018450:Disease Progression; D006801:Humans; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012422:Rupture, Spontaneous; D013997:Time Factors; D014463:Ultrasonography
D003287:Contrast Media