Evidence map›Paper›PMID 42088378›Full record

ReviewJournal of ultrasonography2026

Microvascular flow imaging in musculoskeletal ultrasound: from technical innovation to clinical integration.

Giulia Pacella, Michela Bruno, Ludovica Liguori, Annamaria Pascale, Raffaele Natella, Marcello Zappia

Abstract readReview
In one paragraph

Review in Journal of ultrasonography, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Giulia PacellaDepartment of Medicine and Health Science, University of Molise,Italy.ORCID https://orcid.org/0009-0003-3509-0288
Michela BrunoDepartment of Medicine and Health Science, University of Molise,Italy.ORCID https://orcid.org/0009-0000-4024-1309
Ludovica LiguoriDepartment of Medicine and Health Science, University of Molise,Italy.ORCID https://orcid.org/0009-0008-0795-4233
Annamaria PascaleDepartment of Medicine and Health Science, University of Molise,Italy.ORCID https://orcid.org/0009-0006-8449-7035
Raffaele NatellaDepartment of Radiology, Trotula de Ruggiero Foundation,Italy.ORCID https://orcid.org/0000-0002-5093-8692
Marcello ZappiaDepartment of Medicine and Health Science, University of Molise,Italy.ORCID https://orcid.org/0000-0002-4867-5344

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent advances in Doppler ultrasound have led to the development of microvascular flow imaging, a technique designed to overcome the limitations of color and Power Doppler in detecting slow, small-vessel flow. This narrative review summarizes the technical foundations, clinical applications, and emerging perspectives of microvascular technologies in musculoskeletal ultrasound, emphasizing their role as a bridge between morphological and functional imaging. Microvascular flow imaging employs spatiotemporal clutter-suppression algorithms and high-frame-rate acquisition to visualize low-velocity blood flow within capillaries smaller than 100 µm, without the need for contrast agents. The method enhances detection of microvascularity in tendons, synovium, and peripheral nerves, providing early indicators of inflammatory or degenerative activity. Proprietary vendor implementations share the same physical principles but differ in algorithmic filtering and signal rendering. Clinically, microvascular flow imaging has demonstrated superior sensitivity compared with Power Doppler for detecting subclinical synovitis, assessing tendinopathies, and evaluating entrapment neuropathies, offering both quantitative and prognostic insights. Although microvascular flow imaging improves diagnostic sensitivity and supports dynamic, contrast-free assessment of tissue perfusion, its routine implementation remains limited by the absence of standardized acquisition protocols, validated quantitative metrics, and inter-vendor harmonization. Ongoing research into AI-based vascular quantification and portable point-of-care systems may enhance reproducibility, accessibility, and integration into everyday musculoskeletal imaging. Overall, microvascular flow imaging represents a pivotal step toward functional musculoskeletal ultrasound, with expanding diagnostic, prognostic, and theranostic potential.

Indexed as

microvascular flow imagingmicrovascular technologiesmusculoskeletal ultrasoundPower Dopplerrheumatic diseases

Identifiers

PMID42088378
PMCPMC13136533

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.