Background: Carotid artery atherosclerosis is a major risk factor for ischemic stroke. This risk is related to plaque vulnerability and is characterized by plaque morphology, intraplaque neovascularization, and cerebral microembolization. Advanced neurosonology can identify vulnerable plaques and aid in preventing subsequent stroke. We aimed to assess the time course of cerebral microembolization and intraplaque neovascularization during 6 months of follow-up and to explore the utility of advanced neurosonology in patients with acute cerebral ischemia. Methods: Fifteen patients with acute cerebral ischemia and carotid artery plaques underwent comprehensive extra- and intracranial ultrasound examinations, including microemboli detection and contrast-enhanced ultrasound. The examinations were repeated after 3 and 6 months. Results: We examined 28 plaques in 15 patients. The ultrasonographic features of plaque vulnerability were frequent in symptomatic and asymptomatic plaques. There were no significant differences in stenosis degree, plaque composition, plaque surface, neovascularization, or cerebral microembolization between symptomatic and asymptomatic plaques, but symptomatic plaques had a higher number of vulnerable features. None of the patients had recurrent clinical stroke or transient ischemic attack during the follow-up period. We observed a decrease in cerebral microembolization at 6 months, but no significant change in intraplaque neovascularization. Conclusions: In patients with acute cerebral ischemia and carotid artery plaques, cerebral microembolization decreased during 6 months of follow-up, indicating plaque stabilization. Clinical Trial Registration:ClinicalTrial.gov, identifier NCT02759653.

中文翻译：

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通过高级神经超声学评估颈动脉斑块脆弱性的过程。

背景：颈动脉粥样硬化是缺血性卒中的主要危险因素。这种风险与斑块易损性有关，以斑块形态、斑块内新生血管形成和脑微栓塞为特征。先进的神经超声可以识别易损斑块并有助于预防后续中风。我们的目的是评估 6 个月随访期间脑微栓塞和斑块内新生血管形成的时间进程，并探讨先进神经超声在急性脑缺血患者中的应用。方法：15 名患有急性脑缺血和颈动脉斑块的患者接受了全面的颅外和颅内超声检查，包括微栓子检测和对比增强超声检查。3 个月和 6 个月后重复检查。结果：我们检查了 15 名患者的 28 个斑块。斑块易损性的超声特征在有症状和无症状斑块中很常见。有症状和无症状斑块在狭窄程度、斑块组成、斑块表面、新生血管形成或脑微栓塞方面没有显着差异，但有症状斑块具有更多的易损特征。在随访期间，没有患者出现复发性临床卒中或短暂性脑缺血发作。我们观察到在 6 个月时脑微栓塞减少，但斑块内新生血管形成没有显着变化。结论：对于急性脑缺血和颈动脉斑块患者，随访 6 个月期间脑微栓塞减少，表明斑块稳定。临床试验注册：