Ultrasound imaging of atherosclerotic plaques

The development of techniques for imaging the molecular mediators of atherosclerosis is an area of great interest. The ability to image vascular phenotype will create new opportunities for assessing patient risk for aggressive disease at a very early stage and for choosing appropriate treatment strategies in late stages of disease. Ultrasound will undoubtedly play an important role in molecular imaging because of its practicality as a screening test and because intravascular imaging approaches are already widely used as an adjunct to angiographic procedures. This review focuses on the biophysical principles for the diverse set of tools used to evaluate atherosclerosis. General strategies for imaging vascular phenotype include: 1) assessment of histomorphometry by radiofrequency analysis of high-frequency ultrasound; 2) assessment of plaque content by vascular elastic properties; 3) detection of remodeling of the vasa vasorum by contrast ultrasound; and 4) imaging endothelial molecular phenotype with targeted ultrasound contrast agents.