title: Contrast-enhanced ultrasound: clinical applications in patients with atherosclerosis.
abstract: Contrast-enhanced ultrasound (CEUS) is increasingly being used to evaluate patients with known or suspected atherosclerosis. The administration of a microbubble contrast agent in conjunction with ultrasound results in an improved image quality and provides information that cannot be assessed with standard B-mode ultrasound. CEUS is a high-resolution, noninvasive imaging modality, which is safe and may benefit patients with coronary, carotid, or aortic atherosclerosis. CEUS allows a reliable assessment of endocardial borders, left ventricular function, intracardiac thrombus and myocardial perfusion. CEUS results in an improved detection of carotid atherosclerosis, and allows assessment of high-risk plaque characteristics including intraplaque vascularization, and ulceration. CEUS provides real-time bedside information in patients with a suspected or known abdominal aortic aneurysm or aortic dissection. The absence of ionizing radiation and safety of the contrast agent allow repetitive imaging which is particularly useful in the follow-up of patients after endovascular aneurysm repair. New developments in CEUS-based molecular imaging will improve the understanding of the pathophysiology of atherosclerosis and may in the future allow to image and directly treat cardiovascular diseases (theragnostic CEUS). Familiarity with the strengths and limitations of CEUS may have a major impact on the management of patients with atherosclerosis.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. a.schinkel@erasmusmc.nl.
authors.forename: Arend F L
authors.initials: AF
authors.lastname: Schinkel
authors.affiliation: Division of Angiology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Kaspar
authors.affiliation: Division of Angiology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Staub
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D001158:Arteries / Q000000981:diagnostic imaging*; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000628:therapy; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D003287:Contrast Media / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D006801:Humans; D045423:Microbubbles; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009389:Neovascularization, Pathologic; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Aortic aneurysm; Atherosclerosis; Carotid artery; Contrast-enhanced ultrasound; Echocardiography; Endoleak; Endovascular aneurysm repair; Intima media thickness; Molecular imaging; Myocardial perfusion imaging; Thrombus