Ultrasound Elastography: A new era for vulnerable carotid plaque imaging?

The structure of atherosclerotic plaques causing carotid stenosis is more important than their diagnosis alone since certain types are known to be more prone to thromboembolism than others. Establishment of unstable plaques with high stroke risk is essential for selection of patients who would undergo vascular intervention. Plaque vulnerability is defined by the elastic properties of vessel wall and the plaque composition itself. Iden - tification of vulnerable plaques have been investigated by several imaging modalities. Non-invasive vascular elastography has been recently introduced to evaluate mechanical properties of superficial arteries. In this article, the literature has been reviewed for the studies conducted with non-invasive vascular elastography to analyse in vivo human carotid wall elasticity and plaque biomechanics. Studies on larger patient populations are required to further establish the utility of non-invasive vascular elastography.