Séance 3. ACQUISITIONS RÉCENTES DANS LE DOMAINE DES EXPLORATIONS VASCULAIRES

Résumé

Vascular ultrasound and more generally ultrasound have progressively become a diagnostic potential tool for an
increasing number of users, for different purposes or interests, but closer to the concept of easy-to-use and readydiagnostic systems. During the last 10 years the constant effort of Industry, combined with the feedback of users,
have allowed to improve the ultrasound image quality and the accuracy of Doppler and color modules for vascular
applications, through higher performance of probes and of the software dedicated to various applications, improvingat the same time many ergonomics details too. If the concepts of rapid ultrasound (echo-fast) and ultrasound to the
patient’s bed (bedside) have imposed to find technical solutions to realize machines more and more small, durable
and user-friendly, allowing quickly and effectively diagnosis, on the other hand increasingly sophisticated machines
have been made for second-level functions or research, essential for advanced diagnostics and for development.
Moreover, the development of contrast-enhanced ultrasound (CEUS) imaging with microbubble contrast agents has
provided a unique means of visualizing and quantifying tissue perfusion, offering significant advantages in terms of
real-time imaging, convenience, cost and patient safety. Contrast-enhanced ultrasound is a noninvasive imaging
modality that is capable of assessing, for example, atherosclerotic carotid lesions at risk for rupture. It can distinguish
macrovascular morphology and is able to detect the microvasculature network including visualization of intraplaque
neo-vascularization: this imaging technique is readily available at the bedside and can be performed with minimal
patient discomfort. Contrast echography may be used also in oncology to identify neo-vascularized areas and in the
next future contrast media will may be used also for therapeutic applications including the use of microbubbles to
enhance delivery of agents (like drugs, genes, growth factors, etc.) to the endothelium or perivascular cells for the
control of tissue proliferation. In addition, new applications like as elastography, Acoustic Radiation Force Impulse
(ARFI) and Brain Parenchyma Sonography (BPS) have demonstrated to be useful for identification of carotid plaque
at risk and for the study of several parenchymal lesions of different nature.