Contrast-Enhanced Ultrasound in the Assessment of Carotid Atherosclerotic Disease: A Review

Abstract

Contrast-enhanced sonography is a safe, radiation-free, and minimally invasive imaging technique. It takes advantage of the nonlinear behavior of microbubble contrast agents to produce microbubble-only images, which allows for the assessment of the extracranial carotid arteries, with a minuscule total dose of <1 mL. This review highlights the current status of extracranial carotid sonography imaging, including plaque characterization when using standard and contrast-enhanced sonography.Learning Objective: Describe risk factors associated with ischemic stroke and the associated imaging features and how contrast-enhanced sonography can provide direct evaluation for carotid artery stenosis as well as characterization of atherosclerotic plaque.