Application of multimodal ultrasound in the biomechanical evaluation of carotid intima-media thickness in type 2 diabetes mellitus: a focus on subclinical vascular changes

Objective: To assess multimodal ultrasound technology in the biomechanical assessment of carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM), specifically focusing on those with increased cIMT but without atherosclerotic plaques or significant stenosis. Methods: In this exploratory cross-sectional study, 65 T2DM patients (thickened vs. normal cIMT) and 27 controls were examined using color Doppler ultrasound flow imaging (CDFI), ultrasound vector flow imaging (V-Flow), and ultra-fast pulse wave velocity (UF-PWV). Measurements included peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), resistance index (RI), wall shear stress (WSS), pulse wave velocity at the beginning of systole (PWV-BS), and pulse wave velocity at the end of systole (PWV-ES). Differences across groups and independent factors associated with cIMT were analyzed via correlation and multivariable linear regression. Results: = 0.039) remained independently associated with cIMT. Conclusion: Preliminary findings suggest V-Flow and UF-PWV imaging may detect biomechanical alterations in T2DM patients. While these techniques may offer insights into subclinical vascular remodeling prior to plaque formation, this cross-sectional study should be cautiously interpreted as hypothesis-generating.