Cantisani Vito, Di Leo Nicola, David Emanuele, Clevert Dirk-André
Department of Radiological, Oncological and Anatomopathological Sciences-Radiology, "Sapienza" University of Rome, Rome, Italy, Universita degli Studi di Roma La Sapienza, Roma, Italy.
Radiological Sciences, Radiology Unit, Papardo-Hospital, Messina, Italy, Messina, Italy.
Ultraschall Med. 2021 Aug;42(4):348-366. doi: 10.1055/a-1403-2400. Epub 2021 Apr 29.
In recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.
近年来，超声造影（CEUS）在临床实践中的应用为动脉疾病研究领域开辟了新视野，因为该技术能够提供对患者管理至关重要的新数据集。CEUS在动脉系统中的主要应用包括检测、表征和随访颈动脉斑块以及腔内修复术后内漏。CEUS被证明是一种有用工具的其他情况包括大血管血管炎、夹层和未治疗的动脉瘤。在颈动脉粥样硬化中，CEUS不仅能够获取有关狭窄的定量数据，还能够对斑块进行定性评估。CEUS能够描绘的最重要的斑块特征是溃疡、新生血管形成和炎症浸润的存在。所有这些因素都导致斑块易损性。因此，CEUS对于实现更好的患者风险分层和管理至关重要。在腔内修复术后的随访中，CEUS显示出与CTA相似的敏感性和特异性值，同时具有若干优势，如成本较低、无电离辐射和肾毒性药物。此外，CEUS能够对内漏进行实时评估，因此在CTA结果不明确的情况下是一种有用的工具。大多数局限性与患者相关，与所有其他超声技术相同，如高体重指数和腹胀。
