Contrast-enhanced carotid ultrasound: current status

Unstable atherosclerotic plaques (ASP) are the cause of acute ischemia in the carotid and coronary systems. Numerous studies have shown a relationship between plaque instability, manifestations, echogenicity, histological findings and its neovascularization. The presence and extent of ASP neovascularization in the carotid arteries can be detected for the first time using contrast-enhanced carotid ultrasound. Contrast-enhanced carotid ultrasound does not have nephrotoxic effect; it also improves the accuracy of plaque ulceration detecting and determining the severity of stenosis. The article presents the opinions of the authors and international experts on contrast ultrasound of peripheral arteries. An analysis of the literature data and our own observations is presented. Significant parameters such as the doses, procedure onset time and duration, methods for the qualitative and quantitative assessment of plaque neovascularization are analyzed. The difficulties of contrast-enhanced ultrasound are described.