From the Guidelines
The best type of ultrasound to assess for vascular calcification is Duplex ultrasound (DUS), which includes B-mode echography, pulsed-wave Doppler, colour Doppler, and power Doppler, as it provides a comprehensive evaluation of vascular lesions and quantifies their extent and severity 1.
Key Features of Duplex Ultrasound
- B-mode ultrasound is a robust technique for measuring intima-media thickness (IMT), a marker of atherosclerotic burden and predictor of cardiovascular morbidity and mortality 1
- Colour Doppler and Power Doppler provide detailed images of blood flow and vessel structure, allowing for accurate evaluation of vascular health and detection of potential issues such as stenosis or thrombosis 1
- Pulsed-wave Doppler quantifies blood flow and detects severe stenoses by measuring peak systolic velocities 1
Advantages of Duplex Ultrasound
- Widely available for screening and diagnosis of vascular lesions 1
- Allows for complete vascular evaluation of different beds and is often the first step in clinical management 1
- New techniques, such as B-flow imaging or live three-dimensional (3D) echography, and the use of ultrasound contrast agents, can further improve the performance of DUS 1
From the Research
Vascular Ultrasound Technologies
There are several vascular ultrasound technologies that can be used to assess vascular calcification, including:
- Directional power Doppler ultrasound
- Contrast-enhanced ultrasound
- B-flow imaging
- Microvascular imaging
- 3-dimensional vascular ultrasound
- Intravascular ultrasound
- Photoacoustic imaging
- Vascular elastography 2
B-Flow Imaging
B-flow imaging has been shown to be effective in detecting vascular dissection and has a higher sensitivity than color-coded Doppler and power Doppler sonography 3. The sensitivity of B-flow for detecting all dissections was 98%, compared to 78% for color-coded Doppler and 84% for power Doppler.
Dynamic Flow Ultrasound
Dynamic flow ultrasound (DFUS) is a new color Doppler imaging method that has been shown to have better B-mode imaging and fewer blooming effects and color noises compared to color Doppler US and power Doppler US 4. DFUS has been found to have a superior imaging quality than CDUS and PDUS in demonstrating vessel signals of thoracic lesions.
Color Doppler Ultrasound
Color Doppler ultrasound has been found to be accurate in assessing renovascular hypertension, with a sensitivity of 95.33%, specificity of 88.14%, and overall accuracy of 91.94% compared to digital subtraction arteriography 5. It has also been found to be accurate in diagnosing deep venous thrombosis, with a sensitivity of 100% and specificity of 91.7% compared to venography 6.
Assessment of Vascular Calcification
While the provided studies do not directly address the assessment of vascular calcification, they do demonstrate the effectiveness of various ultrasound technologies in detecting vascular abnormalities. B-flow imaging, in particular, has been shown to be effective in detecting vascular dissection and may be useful in assessing vascular calcification. However, further research is needed to determine the best type of ultrasound for assessing vascular calcification.