Ultrasound technology is a vetted and reliable diagnostic imaging method that has been used in medicine for more than 80 years. It is an invaluable tool for detection, diagnosis, and surveillance of vascular disease. With early detection, vascular disease is treatable and, in some cases, symptoms can even be reversed. Detection and diagnosis can be improved even further thanks to vascular imaging advancements and new vascular ultrasound techniques.
Vascular Imaging Advancements
Recent advancements in vascular imaging technology and techniques can lead to improved outcomes for patients with vascular disease. Doppler ultrasound is currently the leading vascular ultrasound imaging method, and it uses Doppler technology to measure speed and direction of blood flow within the veins.
Microvascular Imaging
Microflow, or microvascular imaging (also known as SMI), is an advanced Doppler ultrasound technique. Studies show that it can be used to detect low velocity blood flow in smaller blood vessels. This technique uses adaptive vessel wall filters to provide a more selective look at these ‘microvessels’. In a clinical vascular ultrasound setting, this new technique could be used to identify vulnerable plaques, although more studies are needed to standardize the process.
Vector Flow Imaging
Vector flow imaging, or VFI, is a vascular imaging method that can allow for visualization of multi-directional blood flow in real time. It uses a multi-ultrasound-beam approach to measure velocity along multiple axes, rather than along the direction of a single ultrasound beam in traditional Doppler ultrasound. Vector flow imaging can also include ultrafast ultrasound imaging, which can provide a more detailed look at blood flow velocity. This method can provide measurements of vessel wall shear stress as well, which affects vascular health. Vector flow imaging analyzes disturbances in blood flow patterns, however as a novel technique, more clinical evidence is needed for routine use.
Elastography
Ultrasound elastography is an imaging method that tests the elasticity of arterial walls to identify vulnerable atherosclerotic plaques. This method provides a more in-depth view of the composition of blood vessels and evaluates stiffness of the veins, which is an indication of cardiovascular risk.
Strain elastography measures the displacement of tissues under different external or internal forces. This method quantifies the resulting strain, which can indicate vulnerable plaques. Another type of elastography is shear-wave elastography, which uses a transverse wave emitted by the ultrasound transducer to measure elasticity. Since these methods are new in clinical vascular ultrasound, more studies are needed to reach a consensus on optimal parameters.
3D Imaging
3D imaging refers to an ultrasound technique that combines cross-sectional slices or 2D images into a 3D image via computer reconstruction. The goal of 3D imaging is to provide a more accurate overview of vein and vessel anatomy to assess plaques. There are currently three different types of 3D imaging: mechanical, matrix, and freehand. Mechanical 3D imaging uses a transducer that automatically moves to capture specific 2D frames to be reconstructed. Matrix 3D imaging also uses a specialized transducer that can capture a larger imaging volume rapidly. Freehand 3D imaging uses a tracking system attached to the transducer, and it relies on manual maneuvers from the ultrasound technologist.
Each method has pros and cons in terms of accuracy, adjustability, and image resolution. However, it can lead to a more complete picture and ultimately provide more accurate assessment of plaques.
Vascular Ultrasound Techniques
Another technique for improving the accuracy of these different vascular imaging methods is multiparametric ultrasound. Multiparametric ultrasound uses multiple advanced imaging techniques to provide a more comprehensive assessment. This can be a combination of both existing and novel vascular ultrasound techniques.
For example, current peripheral arterial duplex exams can be used to diagnose peripheral arterial disease (PAD). The leading cause of this disease is atherosclerosis, which is a buildup of fatty plaque in the arterial walls. Since plaque buildup can result in stiffness of the veins, registered vascular technologists can check for this during an exam. By combining a peripheral arterial duplex exam with the advanced method of elastography, a more complete picture of stiffness in the veins can be achieved.
It’s important to note that while recent advances in vascular ultrasound imaging technology can provide more detailed and comprehensive results in some cases, the technology is still new. Overall, more research is needed before widespread application to clinical vascular ultrasound. As a leading provider of vascular ultrasound in California, Mint Medical is committed to providing vetted, quality vascular care while keeping up to date with vascular imaging advancements and the latest ultrasound technology. Learn more about Mint Medical vascular ultrasound services here.
Guest Contributor: Jordan Galerkin
Sources:
- Atherosclerosis. Mayo Clinic. www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569
- Karl Dussik, Pioneer in Ultrasound. Obstetric Ultrasound History. https://www.ob-ultrasound.net/dussikbio.html
- Özhan Oktar S, Cerit MN, Şendur HN, Karabörk Kılıç AC. Recent advances in vascular ultrasound imaging technology and their clinical implications. Diagn Interv Radiol. 2026;32(1):47-56.
- Yao Y and Zhang P (2023) Novel ultrasound techniques in the identification of vulnerable plaques—an updated review of the literature. Front. Cardiovasc. Med. 10:1069745. doi: 10.3389/fcvm.2023.1069745
