Jan Sloves: Integrating Structure, Mechanics, Hemodynamics, and Microvascular Perfusion in Vascular Ultrasound
Jan Sloves, President and Consultant at Vascular Imaging Professionals LLC, shared a post on LinkedIn about a recent article by Suna Özhan Oktar et al. published in Diagnostic and Interventional Radiology:
“This Paper Captures Where Vascular Ultrasound is Headed: Integrating Structure, Mechanics, Hemodynamics and Microvascular Perfusion. Excellent Review by Suna Özhan Oktar and Colleagues.
My Take Home Summary:
•Vascular ultrasound is evolving into a multiparametric platform that integrates stiffness metrics, elastography, vector flow, microvascular imaging, 3D US, and CEUS in a single exam
•Carotid stiffness and pulse wave velocity now provide quantifiable ‘arterial age,’ predicting cardiovascular events even in asymptomatic patients, with automated RF and speckle‑tracking tools making this feasible at the console
•Shear wave elastography adds plaque biology on top of lumen assessment by differentiating softer lipid/hemorrhagic components from fibrous and calcified tissue, helping to flag truly vulnerable plaques, even though it remains investigational
•Vector flow imaging and wall shear stress mapping visualize complex jets, vortices, and low/high shear zones that drive plaque formation and rupture, pushing us beyond a single ‘percent stenosis’ mindset
•Microvascular (slow‑flow) imaging and CEUS open a window into the microcirculation detecting intraplaque neovessels, tumor vascularity, and endoleaks with performance that often correlates with histology and CT/MR angiography
•Three‑dimensional vascular ultrasound delivers reproducible plaque and aortic sac volumes, enabling radiation‑free and contrast‑free tracking of plaque burden, statin response and EVAR outcomes
•Together, these technologies support a shift toward routine vascular labs that report morphology, mechanics, hemodynamics and microvascular signals rather than just grayscale plus peak systolic velocity”
Title: Recent advances in vascular ultrasound imaging technology and their clinical implications
Authors: Suna Özhan Oktar, Mahi Nur Cerit, Halit Nahit Şendur, Atiye Cenay Karabörk Kılıç
Read the Full Article on Journal of Diagnostic and Interventional Radiology

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