Background: Wall shear stress (WSS) plays an indispensable role in shaping the trajectory of vascular diseases such as atherosclerosis and aneurysms. Specific patterns of low and oscillating WSS are implicated in the promotion of plaque accumulation, whereas elevated WSS levels are associated with inflammatory responses, the synthesis of metalloproteases, and eventual rupture of plaque. Therefore, an accurate, noninvasive quantification of local hemodynamics and WSS is integral to the precise diagnosis of vascular disorders. Ultrasound imaging has emerged as a favored modality for measuring the WSS owing to its noninvasive nature, ease of access, and user-friendly interface. However, existing reviews primarily focus on the assessment of blood flow characteristics, including velocity profiles and volume flow rates. To the best of our knowledge, thus far, no review has been dedicated to ultrasound imaging techniques for the measurement of in vivo WSS.

Purpose: This study aimed to perform a thorough overview of current and emerging ultrasound imaging methodologies tailored for in vivo WSS quantification.

Basic procedure: The fundamental principles of WSS measurements were explored, and various techniques—-Doppler ultrasound imaging, ultrasound imaging velocimetry, and speckle decorrelation—-that are employed for WSS assessment were studied.

Main findings: These techniques show promise for clinical applications by facilitating noninvasive and accurate WSS measurements of vital parameters concerning vascular physiology. Further investigations are warranted to overcome specific challenges, such as the accurate detection of vascular wall boundaries.

Conclusions: The findings of this review are anticipated to contribute to advancements in ultrasound imaging techniques for in vivo WSS measurements.