Prognostic Value of Carotid CEUS in Acute Ischemic Stroke Patients
Prognostic Value of Carotid CEUS in Acute Ischemic Stroke Patients
Contrast-enhanced ultrasound(CEUS) of carotid artery plaque is a novel method that enabled
 direct visualization of neovessels in the vulnerable plaque. Plaque enhancement with CEUS
 showed correlation with the histologic density of neovessels within the carotid plaque and
 the previous cardiovascular events. Vulnerable plaques with a high risk of thromboembolic
 complications and rapid progression is associated with acute ischemic stroke. The prognostic
 value of vulnerable carotid artery plaque depicted with CEUS has not been fully investigated.
 The purpose of this study is to define prognostic value of plaque enhancement on carotid CEUS
 in acute stroke patients. Research question is; in acute ischemic stroke patients with
 ipsilateral carotid plaque as probable etiology of stroke, is the presence of carotid plaque
 enhancement on CEUS independent predictor of future stroke.
Inclusion Criteria:

 1. Patients older than 19 years presenting acute ischemic stroke.

 2. Compatible neurologic symptom within 14 days

 3. Compatible MRI finding (one or more positive DWI lesions in the territory of
 unilateral ICA: ACA or MCA territory) - interpretable MRI image obtained in SNUBH or
 outside hospital

 4. Etiology of acute ischemic stroke: except cardioembolic stroke (Atrial fibrillation)
 and other determined etiology

 5. Ipsilateral extracranial carotid artery stenosis on MRA (CE-MRA), CTA or Doppler
 ultrasound

 Exclusion Criteria:

 1. History of ipsilateral carotid stent or endarterectomy

 2. Carotid intervention during hospital stay

 3. Contraindication to ultrasound contrast agent (SonoVue) A. Right to left,
 bi-directional, or transient right to left cardiac shunts B. History of
 hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or any
 ultrasound contrast agent C. Pregnant or lactating woman D. Unstable cardiopulmonary
 conditions (acute myocardial infarction, acute coronary artery syndromes, worsening
 congestive heart failure, or serious ventricular arrhythmias)

 4. Expected life span less than 12 months